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    Intake Packet for Clients

    Client Intake Information Request (doc)
    Download
    Client Information (doc)
    Download
    Client Assessment-Social Summary (doc)
    Download
    Consent For Medical, Therapeutic, Phychiatric Treatment (doc)
    Download
    Intake Consents (doc)
    Download
    Consent For Release of Confidential Client Info (doc)
    Download
    EYFS HIPAA NOTICE OF PRIVACY PRACTICES (doc)
    Download

    Links

    Updated State Forms

    Microsoft Office 365

    Employee Extended Reach

    EYFS Fax

    PO Box 2877 Snowflake AZ, 85937 Phone: 928/457-0259 Fax: 928/457-0272 ​ 
    www.eagledancer.net