Client Forms for Phoenix Behavioral Health Services, LLC
Please print and fill out the following forms to bring along on your first visit to our office. Also, remember to bring a picture ID and insurance card(s).
All forms are Adobe PDF files. If you have trouble viewing the forms you need, you may need to download and install the free Adobe Reader application.
For Telemedicine sessions, please download and complete and sign the Telemedicine Informed Consent Form and email it firstname.lastname@example.org or mail it to our office –
Phoenix Behavioral Health Services, LLC, 3120 Memorial Drive, Two Rivers, WI 54241
New Patient Forms (Adult)
- New Patient Clinic Policies & Procedures
- New Patient Information Form
- Payment and Credit Policy/Patient
- Client Informed Consent & Acknowledgement of Program
- Medication History
- Intake and Assessment
- Inventory Assessment (BDI)
- Telemedicine Informed Consent Form
- Health Insurance Portability and Accountability Act (HIPPA) Form
New Patient Forms (Child)
We are here to help, contact us for an appointment.