Legacy Mental Health Policies
Easily fill out forms prior to your appointment
Save time before your/your child's first appointment. Print and fill out the forms below and simply bring them in during your scheduled appointment time. If you wish to wait to complete these forms in person, please arrive 15 minutes early.
Forms for Adults:
Client Intake Form for Adults
Permission for ACE to Bill Ins
Guarantee of Account
Outpatient Services Contract
Electronic Communication Policy
Notice of Privacy Practices
Client Rights and Responsibilities
Adult Patient Questionnaire PHQ-SADD
Authorization for Two-Way Release of Confidential Information
Forensic Informed Consent Contract
Forms for Children and Adolescents:
Client Intake Form for Minors
Permission to Treat Minors
Permission for ACE to Bill Ins
Guarantee of Account
Outpatient Services Contract
Electronic Communication Policy
Notice of Privacy Practices
Client Rights and Responsibilities
PHQ-9 Modified for Adolescents (PHQ-A)
Safe Harbor
Authorization for Two-Way Release of Confidential Information