Bio-Behavioral Medical Clinics, Inc.

Our office runs on an "appointment only" basis, and initial appointments are scheduled through our Case Management office. You may call Case Management at 559/437-1111 and discuss your needs with our office staff. Once an appointment is set, there is some paperwork required before we begin; the paperwork is available at our office at the time of your first appointment, or you can expedite the process by downloading and printing the paperwork below and bringing your completed forms to the office at the time of your appointment.

The items below are required for services to be provided:

1.	Please bring 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.		Notice of Privacy Practices (Five pages; download and read only, nothing to complete.)
7.		Acknowledgement of Receipt of Notice of Privacy Practices (Please read and sign where indicated; acknowledges receipt of #6, above.)
8.		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.)
9.		Authorization to Obtain Protected Health Information (Read and sign where indicated if you would like us to receive information from an outside provider or agency.)
10.		Health Insurance Claim Form (Please sign twice near middle of form; no need to complete.)