Complete Forms with Phone, Computer or Tablet
For Follow-Up Appointments
Authorization to Release Information
Authorization to Release Information
This form which should be filled out by an existing patient at or before each follow-up appointment.
Authorization to Release Information
Authorization to Release Information
Authorization to Release Information
This is the form to authorize a release of information.
Mood Form on Behalf of Patient
Authorization to Release Information
Mood Form on Behalf of Patient
This form is completed by a friend, significant other, or family member to assist with evaluation.
Depression Assessments
Depression Assessments
Depression Assessments
This form can be filled out by an existing patient at or before each follow-up appointment.
Sleep Assessments
Depression Assessments
Depression Assessments
This is the form to use to document patient symptoms of sleep disorders
Other Mood Assessment
Depression Assessments
Other Mood Assessment
This form is completed by the patient to assist with the evaluations.
New Patient Forms
New Patient Enrollment
Medical History Questionnaire
Medical History Questionnaire
This is the Enrollment form that is required to become a patient at NCHH.
Medical History Questionnaire
Medical History Questionnaire
Medical History Questionnaire
The Medical History form is essential to your complete team evaluation.
Mood Type Forms
Medical History Questionnaire
Mood Type Forms
You may be asked to complete these specific forms during your Team Evaluation