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Bethel Olentangy Psychological Services



New & Return Patient Paperwork


Please print & complete all forms (except HIPPA notice).  All items to be filled out prior to initial visit will have an asterisk (*).  Simply sign and date ONLY where highlighted, and bring in the day of your appointment.
 

Patients under    18 Years               Old (5 forms)
Parental Consent Form
Pros & Cons of Using Insurance
Release of Information for PCP







Patient Information Form
General Release of Information (optional)
HIPPA Form
 
 

Patients -              18 and Older                  (4 forms)
Pros & Cons of Using Insurance
Release of Information for PCP
Client Information Form









HIPPA Notice
General Release of Information (optional)
 
 
 


                                            Articles
 
Pros and Cons of using insurance
 
Guidelines for Healthy Communication
 
Co-Parenting - The Golden Rules
 
Strategies to help survive dissolution/divorce
 
Say No to Violent Video Games
 
HIPPA Guidelines

        

 

                                Reading Lists


Depression Resources
 
ADD/ADHD Resources
 
Co-Parenting Bibliography
 
Resources on Parenting
 
Recommended Books for Parents & Children/Teens
 
Spiritual Books
 
Stress Management
 
Resources on Parents, Children, & Divorce

Bethel Olentangy Psychological Services