Patient Forms | Bridgeview

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1320 19th Ave., NW, Clinton, Iowa 52732

Main office: (563) 243-5633 Fax: (563) 243-9567

You can find all patient forms here. All documents can be printed, filled out, and brought in to the appointment.

Authorization to Obtain and Release Information Form

Behavioral Health Intervention Consent Form

Bridgeview Client Services Handbook

Client Services Handbook Acknowledgement Form

Community Support Services Consent Form

Intake Family and Health History Form

Intensive Psychiatric Rehab Consent Form

Outpatient Mental Health Consent Form

Payment Agreement Form

Psychiatric Services Consent Form

School-Based Mental Health Consent Form

Statement of Financial Responsibility Form

Adult ADHD Self-Report

Brief Trauma Questionnaire

Child & Adolescent Trauma Screen (CATS): Caregiver 3-6

Child & Adolescent Trauma Screen (CATS): Caregiver 7-17

Child & Adolescent Trauma Screen (CATS): Self-Report 7-17

Generalized Anxiety Disorder Screen (GAD-7)

Patient Health Questionnaire (PHQ-9)

Vanderbilt Assessment Scale - Parent

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