Online Intake/Update Forms

Easily Access our services by calling 1-800-511-5446, or walk into one of our offices near you. No hassle, technology support available if needed.

 

If you need assistance with the forms or have questions, please call us or click the Help button below. 

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You may refer to the Forms on the left side of the page as you complete the Online Forms.

Authorization for Release of Information

Acknowledgement/Consent to Treat

Affidavit

PHQ-9 (Adults)

PHQ-A (Adolescent)

Consent for Medication

Coordination of Care - Information Request

Protected Health Information

Request by an Agency

 

SEMHS Acknowledgement of Treatment

Goals and Service Planning

SHG Ethical and Confidentiality

Acknowledgement Form

 

For assistance with other questions, please call us at 1-800-511-5446

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