Client Intake Forms
At the first appointment, you will be asked to fill out the New Client Intake Forms, Privacy Forms and What To Expect At Your First Appointment Form. These will provide our staff with medical and family history, including any sleep, dietary, injury and other health related issues. We will also assess how the child is coping as well as the parent(s). We would like to get a glimpse into a typical day in the client’s life.
For your convenience, please download all forms and print them. Bring the completed forms to your first visit. You may download them separately, or you may download the entire New Client Packet.
- New Client Packet (required at first visit)
- Client Intake – Secondary Insurance Form
- Client Information Release Consent Form
- Privacy Notice
- Outpatient Services Agreement for Collaterals
- Consent and Agreement for Psychological Testing and Evaluation
- Credit Card Payment Consent Form
- Agor Behavioral Health Services, Inc. Information Brochure (English)
- Agor Behavioral Health Services, Inc. Folleto de información (Español)
We no longer allow clients to email forms. Please download and print forms to be completed and bring to the first appointment. You may also arrive 20 minutes early to complete the forms in the office.