New Client Information and Forms
Welcome to Bridges Healthcare
Thank you for choosing us as your behavioral health provider to support you or your family on your path to recovery and better mental health.
To Become a New Client:
Please contact Bridges to schedule your first appointment with our Intake Department by calling 203-878-6365 ext. 680.
The information below is intended for individuals who have already scheduled their first appointment. If you have not scheduled your first appointment yet, please do not fill out the forms below.
New Clients who Have Scheduled First Appointments:
If you have already scheduled your first appointment, please fill out the appropriate set of electronic forms below to get you started with our agency. They include important guidelines and expectations for our services.
For the Spanish version of these forms, go HERE. For additional language assistance, visit this page.
Please read the following instructions carefully before you begin:
Form Selection & Completion— Select the category below that is appropriate for you or your child’s service needs. Each expandable box holds ALL the specific forms required for each type of client being served. If you are an Adult Client, select “Adult Client Forms” and fill out ALL forms listed in that box. If you are a Parent or Legal Guardian to a child client, go to the “Forms for Parent & Child Clients” section, select the expandable box which is appropriate based on your service location or program type, then fill out ALL forms listed in that box. Please note that some forms may require you to enter the name of the person you’re scheduled to meet in your first appointment. Please ensure you select that person’s name and NOT “Program Admin.”
Estimated Time—The forms take approximately 30 minutes or more to complete. To avoid delays or incomplete records, we recommend completing all required forms in one sitting. Once you’ve finished, your forms will be securely submitted to Bridges Healthcare.
Forms for Adult Clients:
Adult Client Forms
- Notice of Privacy Practices
- Rights and Responsibilities and Consent for Treatment
- Financial Agreement
- Demographic Certification
Forms to Guide Treatment:
- Goals for Service Planning (Adults)
- CAGE-AID
- Modified Mini
- Brief Trauma Questionnaire
- Universal PRIME Screening (Only for Adults ages 18 to 30 years)
Forms for Parent & Child Clients:
Office-Based Services
Parent Forms — Parents or legal guardians, please fill out the following forms.
Child Forms — All new child clients, ages 12-17, are required to complete these forms. Parents, please note that these forms are to be filled out by your child.
School-Based Services
Parent Forms — Parents or legal guardians, please fill out the following forms.
Child Forms — All new child clients, ages 12-17, are required to complete these forms. Parents, please note that these forms are to be filled out by your child.
Intensive In-Home Child & Adolescent Psychiatric Services (IICAPS)
Parent Forms — Parents or legal guardians, please fill out the following forms.
Child Forms — All new child clients, ages 12-17, are required to complete these forms. Parents, please note that these forms are to be filled out by your child.
ConnectiKIN (C-KIN), Intensive Family Preservation (IFP), Care Coordination
Parent Forms — Parents or legal guardians, please fill out the following forms.
Notice to Clients
Bridges Healthcare 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.
Stay Connected
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