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Forms & Documents > Paper Forms > MH + DAS > English

Name Description
ABNEnglish

BH-Consent-for-Injection-Therapy

BH-Progress-Report-7-31-23

ClientAccess

ClientAccessDetermination

Client-Information-New_rev07122023

Consent-for-Photo

Consent-For-Telehealth

Consent-for-Text

Consent-to-Treat

Coordinated-Care-Consent

Coordinated-Care-Consent

Email-Consent_Fillable-PDF_Final2_rev07122023

Informed-Consent-for-Medication

NOABD_English
Notification-of-License-Status

Open-Payments-Database-Notification

Open-Payments-Database-Notification

Patient-Rights-and-Responsibilities

Recovery-Residence-Authorization-Fillable-PDF

Release-of-Information

Safety-Plan

SLOBHD_Your-Rights-Attachment_Rev-July-2020

Smartcare_BH-Cost-Agreement-Writeable_rev07172023

Tarasoff-Fax

Tarasoff-Letter-Template

Tarasoff-Notification

Tarasoff-worksheet

UMDAP

Your-Rights-At-a-Glance

Your-Rights-At-a-Glance

Please contact our access line at 1 (800) 838-1381 for information or to schedule an appointment. All services are available in Spanish.

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