Patient Forms

These forms are provided to assist in expediting and facilitating care. If you are a new or existing patient who has been asked to fill out a specific form(s) prior to your visit, you can find the referenced form below:

All Clients (except DFS/CW) + appropriate screens:

• Registration Form (complete in order to be contacted by our staff about services)
• Intake Packet (complete prior to first appointment)
• Release of Information (ROI) (complete if client wants Healthy Minds to be able to communicate with third party about protected health information)

ADULT MH (Mental Health) Screens:

• MHSF-III
• ADHD Self Report

ADULT SUD (Substance Use Disorder) Screens:

• URICA
• MAST
• DAST

YOUTH MH and/or SUD Screen:

• APA DSM5 Screening

DFS/CW ONLY Clients:

• Intake Packet – DFS ONLY
• ROI – DFS ONLY