Forms

Download and complete the Required Forms packet in advance of your first visit to The Coastal Center.

New Child/Adolescent Client, Download Child Intake Forms

New Adult Client, Download Adult Intake Forms

Each 8-10 page document includes:

1. Patient Information (Child or Adult)

2. Client Agreement

3. HIPPA Notice of Privacy

4. Credit Card Authorization Form

5. Consent Form (only needed if you intend to have The Coastal Center to contact a teacher, school administrator, physician, or other health care provider, please specify the name of The Coastal Center clinician to whom the release of records and information will be made)

These forms are to be printed out at home, filled out completely, and brought to the first session with your clinician.

We ask that you complete the forms at home to optimize your time spent with our clinician.  If you have any questions about any forms, please just ask!

Individual Forms (already included in Adult and Child Package)
CC_Credit_Card_Auth
CC_Consents