New Patient Packet
Information about about our practice and policies as well as registration and consent forms. Please read and complete prior to your first visit.
Questionnaire about medical history and overall health. Complete and sign where indicated.
Authorization to disclose protected health information. Required to send information to an outside provider or agency.
Information Request Authorization
Authorization to request protected health information. Required to solicit information from an outside provider or agency.
Instructions for referring patients to BBMC.
For initial and sub-specialty referrals.
Treatment Authorization Request
Psychiatrist request for additional treatment. (For use with Santé IPA patients.)
Therapist request for additional treatment. (For use with Santé IPA patients.)