|
| New Patients Forms |
 New Patient For MD |
168kb |
|
New Patient For Counselor |
141kb |
Please download and fill out the form and bring it with you to your appointment.
A $60 refundable deposit is required for all new patient appointments at the time of scheduling to confirm and hold the appointment.
This deposit may be applied to the cost of your visit. We are unable to schedule an appointment without a deposit.
To complete your deposit you may issue a check payable to BHC, Inc or call the office and provide your credit card information.
If you are unable to keep your appointment, we ask that you give us at least 24 hours notice. We will happily issue a full refund. If you opt to reschedule your appointment, your deposit will be applied to your new appointment.
We understand that unplanned circumstances can occur and you may need to cancel or reschedule your appointment. If you reschedule or cancel less than 24 hours prior to your reserved time, your deposit will be forfeited and a new deposit will be required to book any future appointment.
|
|
| Request Forms |
Authorization to Release Information |
190kb |
|
Prescription Refill Request |
35kb |
|
Request for Letter |
33kb |
| Please download and fill out the form. You can bring it with you to your appointment or you can fax it to our office. |
|
Having trouble opening up the file?
You'll need Adobe® Acrobat Reader® software (version 6.0 or higher) to view PDF file.
Download Acrobat Reader
|
