Capstone Behavioral Healthcare

CAPSTONE NEW CLIENT INTAKE FORMS

CAPSTONE BEHAVIORAL HEALTHCARE

Program Intake Forms

Please print off and complete forms prior to scheduling your first appointment.  Initial appointments will not be scheduled until all needed paperwork is complete and turned in to the Capstone office.

MENTAL HEALTH SERVICES
Capstone Adult Intake Form.doc          
Child-Adolescent Intake Form for clients under age of 17.doc          
Insurance and Financial Agreement.doc          
Receipt of Client Information - Consent for Treatment.doc          
PATIENT ACKNOWLEDGEMENT AND CONSENT FOR PRIMARY CARE PHYSICIAN NOTIFICATION.doc          
MH Outpatient Psychotherapy Service Description.doc          

SUBSTANCE ABUSE SERVICES
Capstone Adult Intake Form.doc          
Child-Adolescent Intake Form for clients under age of 17.doc          
Insurance and Financial Agreement.doc          
Receipt of Client Information - Consent for Treatment.doc          
SA -OWI FORM.doc          
SA -Screening for AOD Abuse.doc          
PATIENT ACKNOWLEDGEMENT AND CONSENT FOR PRIMARY CARE PHYSICIAN NOTIFICATION.doc          
MH Outpatient Psychotherapy Service Description.doc          

COMMUNITY SUPPORT SERVICES
CSS Referral Intake Information Form--Community Support Services.doc          
CSS Client Rights-Responsibilities Community Support Services.doc          
CSS Agency Intake Referral--Community Support Services.doc