Online Intake Forms

If you are interested in services, please call Southeast Health Group during our open hours at 1-800-511-5446. (See open hours above).

The following forms are available online and should be completed prior to your intake. Please see the Online Forms below. 


Once you complete the forms, please call our office during open hours to complete the intake process. 


You are also welcome to come into the office during our open hours. 


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


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


PHQ-9 (Adults)

PHQ-A (Adolescent)

Consent for Medication

For help completing intake forms only

(click here)


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

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