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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. 



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)

Psychiatric Services “No-Show” Policy

Consent for Medication

Coordination of Care - Information Request

Record Request Form


SEMHS Acknowledgement of Treatment

Goals and Service Planning

SHG Ethical and Confidentiality

Acknowledgement Form

Specialty Service Form


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

Online Surveys

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