17305 Cedar Ave. Suite 230, Lakeville, MN 55044
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Forms

For your convenience you can download the following forms and print them off.  Please complete the forms that apply to you and bring with you to your first appointment.

PDF reader is required to download these forms. The reader can be downloaded at http://www.adobe.com/products/acrobat/readstep2.html for free.

 
Adult Symptom Assessment

Adult Intake Form

Adolescent Intake Form Completed by Parents 
 
Adolescent Intake Form Completed by the Adolescent

Child Intake Form
 
Release of Information Form

View Our Privacy Policy

Forms to be signed by all clients. For children under 18, parents will sign.

BCHC Policies

Assignment of Insurance

Notice of Privacy Practices

Stories of Hope was very inspirational and good for our world and good for our souls.

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