New Client Information and Forms

Welcome to Bridges Healthcare. We are pleased that you have chosen us as your behavioral health services provider.

If you have not reached out to Bridges for an appointment made by the Intake department, please contact Bridges by calling our Main office at (203) 878-6365.

NOTE: If you have not contacted Bridges yet, Please do not fill out these forms below.

For new clients, the forms below will introduce you to the agency and supply you with our guidelines and expectations of our services. You will be asked to fill out registration forms electronically.

Please complete all the forms designated by the intake department. For your best experience, we strongly encourage you to complete all required forms in one sitting to prevent incomplete records. Please note these forms will take approximately 30 minutes or more to complete.

For the Spanish version of forms, go HERE. For additional language assistance, visit this page.

 

All New Clients

All new adult clients and parents of new child clients please fill out all forms in this section

  1. Notice of Privacy Practice
  2. Rights and Responsibilities and Consent for Treatment
  3. Financial Agreement
  4. Demographic Certification

 

New Adult Clients

All new adult clients please also fill out the forms in this section.

  1. Goals for Service Planning (Adults)
  2. CAGE-AID
  3. Modified Mini
  4. Brief Trauma Questionnaire
  5. Universal PRIME Screening (Only for Adults ages 18 to 30 years)

Parents

Parents of new child clients (All Ages) please fill out all forms in this section.

  1. Goals for Service Planning (Youth)
  2. Child Development History
  3. THS Screening

 

Children

All new child clients, ages 12 through 17, please fill in these forms. Parents: These forms are to be filled out by your child.

  1. GAIN SS 
  2. Universal PRIME Screening 

 

Attachments

 

Notice to Clients 

This practice serves all clients regardless of ability to pay. Discounts for essential services are offered based on family size and income. For more information, ask at the front desk or see policy here.

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