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  • 866.938.4159
  • Providers
  • Locations
    • Iowa
    • Minnesota
    • Missouri
    • North Dakota
    • Wisconsin
  • Services
    • Therapy
    • Psychiatry
    • Substance Use Treatment
    • Psychological Testing
    • Dialectical Behavior Therapy (DBT)
    • Telehealth
    • View All Services
  • Specialties
    • ADHD
    • Anger Issues
    • Anxiety
    • Autism
    • Bipolar Disorder
    • Depression
    • Insomnia
    • LGBTQIA+ Affirming
    • Stress Management
    • Substance Use
    • Suicidal Thoughts
    • Work Issues
    • View All Specialties
  • Referral Partners
    • Make A Referral
    • Referral Forms
  • Resources
    • About Us
    • Blog
    • Everyday Therapy Podcast
    • Self-Help Tips
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  • Find a Location
  • 866.938.4159

Additional Patient Forms (Ellie)

Insightmarketing2025-12-01T11:14:24-06:00

Additional Patient Forms

If you’re having problems accessing any forms, please hit the CTRL + F5 keys on your keyboard.
If you have further questions, please call your clinic.

  • Client Intake Forms
  • Consent & Release Forms
  • Assessments
  • Grievance Form
  • Formularios en ESPANOL

Client Intake Forms

  • Therapy Adult Intake Form
  • Therapy Minor Intake Form
  • Client Bill of Rights
  • Client Responsibilities
  • Couples Therapy Intake Form
  • Safe Harbor Agreement
  • Med Mgmt Adult Intake Form
  • Med Mgmt Minor Intake Form

Consent & Release Forms

  • Client Informed Consent
  • Testing Consent Agreement
  • Minor Letter of Acknowledgement
  • Minor Group Therapy Consent Form
  • Adult Group Therapy Consent Form
  • Release of Information
  • Release of Information Revocation
  • Record Amendment Form
  • Relational Focused Therapy Collaborative Agreement

Assessments

  • CES-DC Form
  • PHQ-9
  • GAD-7
  • CAGE-AID
  • WHODAS
  • SCARED Form

Grievance Form

  • Grievance Form

Formularios en ESPANOL

  • Formulario de Pólizas y Consentimiento Informado
  • Formulario de Consentimiento de Divulgación de Información
  • Acuerdo de “Puerto Seguro”
  • Revocation de la divulgación de información
  • Formulario e Historial del Cliente (para adultos 18+ anos)
  • Formulario e Historial del Cliente (para niños, 0-18 anos)
  • GAD-7
  • PHQ-9
  • WHODAS
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866.938.4159

Main Office: 1900 Silver Lake Rd.
New Brighton, MN 55112

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