Before Your First Appointment
Multiple forms need to be filled out and brought with you to your first appointment, as well as your insurance card and photo ID, which will be photocopied for our billing records. Please give the completed forms to our business staff at the front desk when you arrive. You can either print these forms out and bring hard copies, or you can email them to us at [email protected].
Northeast Youth & Family Services would like to thank you in advance for choosing our agency for your health care needs. It is our pleasure serving you.
English Forms
- Authorization for Release of Information
- Adult Contact Form
- Attendance Policy
- Telehealth Consent
- Client Rights and Responsibilities
- Parent/Guardian Consent for Treatment of a Minor
- Email and Text Consent
- Fee Agreement
- Youth Contact Form
- Primary Care for Release of Information
- HIPAA Policy
- The CAGE Questionnaire for Adolescents Age 12 and Over
- PHQ-9
- GAD-7
