Behavioral Health Intake Forms
- Acknowledgement-of-Notice-of-Privacy-Practices English_2-27-18
- BH-Application_English_01_25_2022
- BH-Application-SPANISH_01_25_2022
- BH-Consent-for-Treatment-v5_7-16-18
- BH-CONSENTIMIENTO-PARA-EL-TRATAMIENTO_7-16-18
- Acknowledgement-of-Notice-of-Privacy-Practices Spanish_2-27-18
- Cost-Explanation-and-Agreement 07_01_2022
- Explicacion-de-Costo-y-Acuerdo
- Health-Questionnaire English 2022
- Health-Questionnaire Spanish_2022
- Notice-of-Privacy-Practices_English_1-18-19
- Notice-of-Privacy-Practices_Spanish
- PRJUSD-Referral-Packet-11-2023