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Advanced Mental Health Center
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Forms

Forms: Before Your Appointment

If you're a new client, please complete the following forms and bring them to your first therapy session.

Intake Form
Consent Form
HIPAA Acknowlegment Form
New Client Registeration Form
Fee Agreement

If you would like us to contact other providers (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:

Authorization To Release of Confidential Information Form

Advanced Mental Health Center
17514 Ventura Boulevard, Suite 100 Encino, CA 91316 | Phone: (310) 877-0600