| New Patient Pack |
This is a complete pack of forms for new patients |
| Telehealth Consent |
This form is for telehealth services. |
| Email Consent |
This form for consent for email communication. |
| Patient Registration Form |
This form contains patient address, insurance, contact information, and other registration information |
| Medical Records Authorization |
This authorization form directs your other providers to release your medical records to the Charis Clinic |
| Health Information By Alternate Means |
This form authorizes Charis Clinic to leave health information for you by email, voice message or text |
| Financial Policies |
This form contains our financial, payment and credit card policies. |
| Notice of Privacy Practices |
This form contains our privacy practices |
| Acknowledgement Privacy Practices |
This form acknowledges receipt of our privacy practices |
| History and Screening Forms |
Description |
| Child History |
Our history form for children |
| Adult History |
Our history form for adults |
| Child Anxiety Screening Form |
This contains the SCARED anxiety screening form |
