Patient Forms

Please complete ALL of the RBH New Patient Forms listed below prior to your first appointment.

• Medication List
• New Patient Registration Form
• Psychological services Informed Consent
• RBH HIPAA Notice
• NON Court Related Services
• RBH Telehealth Consent Form
• RBH Patient Financial Responsibility Consent Form
• RBH Patient Financial Responsibility Informed Consent Form
• RBH Community Care Clinic Consent Form

Please complete this form is the patient is a minor (< 18 years old):

• Consent for Treatment of a Minor

Please complete this form to authorize RBH to release information to another party:

• RBH Authorization to Release Information

Please complete these forms if you are interested in QEEG Brain Mapping, Neurofeedback, and/or Neuromodulation therapy:

• QEEG & Neurofeedback Informed Consent
• Neurofield Neurotherapy Informed Consent Form
• QEEG & NFB services Consent Form