PATIENT PORTAL

Patient Portal Login Page

HEALTH & WELLNESS PATIENT FORMS

New Patient Form

New Patient Form- Under 18
Covid Policy
Authorization for Use and Disclosure
General Consent to Treatment & Financial Responsibility
Rx Forms
Telahealth Agreement

IMPACT BEHAVIORAL HEALTH PATIENT FORMS

Demographics
Informed Consent to Treatment
Child’s Social Development History
Release of Records
Authorization for Insurance
Privacy Practices