ISABELLA CITIZENS FOR HEALTH, INC.
  • HOME
  • Providers
  • Contact & Hours
    • Contact & Hours
    • Walk - In Hours
  • Administration
    • LEADERSHIP TEAM
    • Quality
    • Funding & Donations
    • Board of Directors
    • Patient-Centered Medical Home
  • FOR PATIENTS
    • Billing
    • New Patient Information
    • School-Based Forms
    • Sliding Fee Scale Program
    • COVID-19
    • No Surprises Act
    • Non-Compliance Concern Form
    • Patient Portal
  • Services
    • BEHAVIORAL HEALTH SERVICES
    • Resources/Services
    • ON-SITE PHARMACY
    • Quest Diagnostics
    • School-Based Services
    • WOMEN'S HEALTH
    • SERVICES
    • Community Health Worker Assistance

School-Based Forms

Services require the following Consent for Treatment form to be completed by a parent or guardian prior to services, and returned to the School-Based Outpatient Therapist: 
Consent for Treatment Form 
​
​Other Forms:
Email-Text Consent Form
Release of Information/Records Release Form

Proudly powered by Weebly
  • HOME
  • Providers
  • Contact & Hours
    • Contact & Hours
    • Walk - In Hours
  • Administration
    • LEADERSHIP TEAM
    • Quality
    • Funding & Donations
    • Board of Directors
    • Patient-Centered Medical Home
  • FOR PATIENTS
    • Billing
    • New Patient Information
    • School-Based Forms
    • Sliding Fee Scale Program
    • COVID-19
    • No Surprises Act
    • Non-Compliance Concern Form
    • Patient Portal
  • Services
    • BEHAVIORAL HEALTH SERVICES
    • Resources/Services
    • ON-SITE PHARMACY
    • Quest Diagnostics
    • School-Based Services
    • WOMEN'S HEALTH
    • SERVICES
    • Community Health Worker Assistance