New Client Information and Forms

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

To become a New Client, please be sure to contact Bridges to schedule an appointment with our Intake Department.

NOTE: If you have not yet scheduled your first appointment, please do not fill out the forms below.

For new clients who have scheduled their first appointment, 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 Practices
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 complete forms 1, 2, 3, and one from 4.

1. Goals for Service Planning (Youth)
2. Child Development History
3. THS Screening
4. Parental Agreement of Agency Practices (select one based on location of service)
   • • • Office-Based Services
       • Home-Based Services
       • School-Based Services

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

• (Client_Welcome_Packet_2021-02.pdf)
• (DMHAS-Know-Your-Rights-031021-11x17_001.pdf)
• (SPANISH-DMHAS-Know-Your-Rights-031021-11×17-upd.pdf)