Intake Forms For Your First Appointment
After your first appointment, please complete the following three forms as best you can. Be sure to initial and sign the forms where asked to do so.
Click on a link to open a form. You can fill in the form online, then print it to a PDF and email the PDF file to Info4BAHP@Gmail.com.
Or you can download a form, print it out, fill it in, and bring it to the office or scan it to create a PDF file and email the PDF file to us.
If you are using Chrome, the form will open as a fillable form. If you are not using Chrome, you will need a PDF viewer such as Adobe Reader to view the forms. You can download Adobe Reader for free by clicking here.
Please use the following form if you are asked to complete and sign a Consent to Release Information form:
Telephone: (650) 999-0220
Fax: (855) 999-0220
Services offered via telepsych:
Our mailing address:
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