The MH Private Practice Builder Forms & Evaluations
By Kee Consulting
- Consent to Mental Health Treatment
- Intake Form
- Comprehensive Initial Psychiatric Evaluation
- Comprehensive Follow-up Psychiatric Evalutation
- Suicide Safety Plan
- Privacy Practice
- Release of Information
- Concierge Service Consent
- Conciege Description w/Price List
- Lab Prescription
- EKG Prescription
- Walk-In Intake Form
- Emotional Support Animal Letter
- Client Discharge Letter
- Credit Card Authorization
- Benzodiazepine & Stimulant Agreement
- HIPAA Notice of Privacy Practice
- Consent for Treatment: Face-to-Face & Telehealth
- Parental Consent for Child's Treatment: Face-to-Face & Telehealth
- Informed Consent for psychotropic Medications
- Consent for Telehealth Consultation w/Consultation Costs
- Telepsychiatry & Concierge Health Informed Consent for Psychotropic Medications
- Practice Policies (Lateness, C.C. Authorization, Billing, Social Media, Termination, etc.)
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