[et_pb_section fb_built=”1″ admin_label=”Section” module_class=”news-update-home-section” _builder_version=”4.27.2″ _module_preset=”default” background_color=”#3358b5″ use_background_color_gradient=”on” background_color_gradient_stops=”rgba(51,88,181,0.8) 0%|rgba(51,88,181,0.8) 100%” background_color_gradient_overlays_image=”on” background_image=”https://helpushelpuinc.org/wp-content/uploads/HUHU-Services.jpg” custom_padding=”|||0px|false|false” da_disable_devices=”off|off|off” locked=”off” collapsed=”on” global_colors_info=”{}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on”][et_pb_row _builder_version=”4.27.2″ _module_preset=”default” custom_padding=”0px||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_heading title=”Intake Form” _builder_version=”4.27.2″ _module_preset=”default” title_font=”Playfair Display||||||||” title_text_align=”center” title_text_color=”#FFFFFF” title_font_size=”62px” custom_margin=”40px|||||” custom_padding=”||36px|||” title_font_size_tablet=”50px” title_font_size_phone=”35px” title_font_size_last_edited=”on|tablet” global_colors_info=”{}”][/et_pb_heading][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.24.2″ _module_preset=”default” custom_padding=”||45px|||” da_disable_devices=”off|off|off” global_colors_info=”{}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on”][et_pb_row custom_padding_last_edited=”on|phone” _builder_version=”4.24.2″ _module_preset=”default” custom_padding=”0px||7px||false|false” custom_padding_tablet=”0px||||false|false” custom_padding_phone=”0px||0px||true|false” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_accordion open_toggle_background_color=”#ffffff” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”#f7f7f5″ _builder_version=”4.27.2″ _module_preset=”default” toggle_font=”–et_global_heading_font|700|||||||” closed_toggle_font=”–et_global_heading_font||||||||” body_font=”–et_global_heading_font||||||||” body_text_color=”#000000″ body_font_size=”16px” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″][et_pb_accordion_item title=”New Patient Registration Form” open=”on” _builder_version=”4.27.0″ _module_preset=”default” global_colors_info=”{}”]The Patient Intake form is for new patients or patients that have not been seen by a provider in more than two years and is expected to take ten minutes to complete. You will need to complete our Patient Intake Form before your first appointment.
Prefer to print and complete offline? Download PDF or click the ‘Click here’ button below to fill out the form online.
Click Here[/et_pb_accordion_item][et_pb_accordion_item title=”Patient Information Release Form” _builder_version=”4.27.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]Prefer to print and complete offline? Download PDF or click the ‘Click here’ button below to fill out the form online.
Click Here[/et_pb_accordion_item][et_pb_accordion_item title=”Comprehensive Client Consent Form” _builder_version=”4.27.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]
Quickly complete your Comprehensive Client Consent Form online for immediate processing.
Prefer to print and complete offline? Download PDF or click the ‘Click here’ button below to fill out the form online.
Click Here
[/et_pb_accordion_item][et_pb_accordion_item title=” PHQ-9 Form” _builder_version=”4.27.2″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” open=”off” sticky_enabled=”0″]
Prefer to print and complete offline? Download PDF or click the ‘Click here’ button below to fill out the form online.
Click Here
[/et_pb_accordion_item][et_pb_accordion_item title=”Document Requirements Form” _builder_version=”4.27.2″ _module_preset=”default” global_colors_info=”{}” open=”off”]Prefer to print and complete offline? Download PDF or click the ‘Click here’ button below to fill out the form online.
Click Here[/et_pb_accordion_item][/et_pb_accordion][/et_pb_column][/et_pb_row][/et_pb_section]