We provide high quality psychiatric and clinical services to our community.
Bio-Behavioral Medical Clinics, Inc.
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FORMS/INFO
New Patient Forms
Referral Forms
Provider Info
- Psychiatrist
- Therapist
USING THE FORMS
To utilize our forms, you will need Adobe Acrobat®. Press the icon to acquire.
Please complete the forms on your computer as requested, print them, and bring them to your first appointment. Forms may be completed by hand if necessary.
New Patient Forms

Initial appointments are scheduled through our Case Management Office at 559/437-1111. Once an appointment is scheduled, please complete the forms below.

Forms with a may be completed on your computer. Type in the information using your computer's PDF reader or Adobe Acrobat® ... print ... and bring to your initial appointment!

The items below are required for services to be provided:

1. Your current health insurance card and valid photo identification. These are important for verification of your benefits and for your protection.
2.Information and Policies for New Patients (Read only, nothing to complete.)
3. Patient Registration Form (Please complete and sign.)
4. Medical History Form (Please complete.)
5. Consent and Financial Policy (Please read and sign where indicated.)
6. Payment Policy (Please complete and sign.)
7. No Show/Appointment Cancellation Policy (Please read and sign.)
8. Receipt of Notice of Privacy Practices (Complete and sign where indicated.) You may read our Notice of Privacy Practices by clicking here. (Five pages; download and read only, nothing to complete.)
9. Authorization for Disclosure of Protected Health Information (Two pages; read and sign where indicated if you would like us to send information to an outside provider or agency. Also used to revoke a prior Authorization for Disclosure.)
10. Authorization to Obtain Protected Health Information (Read and sign where indicated if you would like us to request information from an outside provider or agency.)
© Bio-Behavioral Medical Clinics, Inc., 2017. All rights reserved.