HDC Forms

Attendance Policy Agreement Form

Authorization for Communication via Texting Form

Authorization to Release Protected Health Information (HDC ROI) Form

Client Complaint Form

Informed Consent and Authorization Form

Intern Informed Consent Form

Mental Health Professionals Under Supervision Informed Consent Form

Parental Consent and Waiver Form

Skills for Psychological Recovery (SPR) Consent Form

Sliding Fee Scale

Telehealth Group Therapy Agreement Form

Telehealth Informed Consent

Adult Intake for First Appointment

Youth Ages 6-17 Intake for First Appointment

Youth Under 6 Intake for First Appointment

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NORTHLAND’S ONLY CCBHC

A Certified Community Behavioral Health Clinic (CCBHC) is an integrated model of care improving service quality and accessibility. This model is the future of community behavioral health with a goal to improve both mental health and substance abuse treatment across the country.