Outpatient Admission Forms

Please download / print the paperwork listed below:

• Confidential Information Packet for Adults & Adolescents (13 yrs & older)
• Confidential Information Packet for Children & Adolescents (17 yrs old & under)
• Consent for Evaluation and Treatment
• Outpatient Consent and Authorization
• General Authorization for Use or Disclosure of Health Information (permission to send a letter to your primary care physician to notify them of your first appointment.)
• Missed Appointment / Late Cancellation Policy
• Child Care Policy
• Notice of Privacy Practices
• Acknowledgement of Notice of Privacy Practices
• Objection Information
• General Information Sheet – Ann Arbor & Canton
• General Information Sheet – Brighton

After completing the forms to the best of your ability, bring them to your first appointment in the clinic. Parents are expected to complete the Confidential Information Packet for Children and Adolescents for their children. All children 13 years of age and older are also expected to complete the Confidential Information Packet for Adults.

Please note that there are additional forms other than the forms listed above that will need to be completed prior to the appointment. The forms that are on-line are for your convenience, and they are also available at check-in. The paperwork takes approximately 45 minutes to complete, so please arrive at the clinic early enough to complete all forms before your actual appointment.