Please complete the four forms below to become a new patient at California Center for Behavioral Health. Each form takes a few minutes. Once all are submitted, our team will reach out to schedule your first visit.
Required for New PatientsIntake Questionnaire
Patient information, medical history, current medications, symptoms, and personal history.
Agreement of Care
Appointment policies, missed appointment fee, billing and payment responsibilities.
Telemedicine Consent
Required for video visits, which is how most appointments are held. California residents only.
Privacy Practices Acknowledgment
Confirms you've received our Notice of Privacy Practices.
Communication Consent Optional
Authorize us to reach you by text message, email, or both. Each method is opt-in independently — appointment reminders, refill notifications, and care-related messages.
Release of Information If requesting records
Authorize us to share your health information with another provider, family member, or agency.
Intake · Care Agreement · Telemedicine · Release of Info · Notice of Privacy Practices · Privacy Acknowledgment · Communication Consent