Dashboard
Admission Checklist
Authorization and Consent
Authorization for Use of Image
Authorization for Use or Release of Information
Belongings List
Consent for Ordinary and Routine Medical and Dental Care
Consent For Services
Consent for Treatment
Geriatric Depression Scale
Inpatient Certificate
Intake Questionnaire
Legal Notice to Patients
Notice Regarding Rights of Recipients
Observation Record
Patient Phone and Visitation Restriction Sheet
Petition For Involuntary/Judicial Admission
Psychiatric Medical Clearance Checklist
Psychotropic Medication Notice and Consent
Rights Receiving Mental Health Services
Suicide Safety Plan
Unit Rules
Sign Forms
Generate Forms
Logout
×
Please, draw your signature
Consent For Services
Patient
Authorized person's name:
Authorized person's capacity:
Consent Validity:
Describe services to be rendered
Authorize the physicians and staff to use their judgement and do whatever they deem advisable except that (list any exceptions):
Refusal to consent to any of the above services may result in these consequences:
Remove