Intake Forms

If you are preparing for your first visit to New Oakland, please click the links below to download the forms you should complete before your visit. Once you have downloaded them, you can print them at any home or office. However, if you can’t print forms, they will also be available for you to complete when you arrive at New Oakland.

 

Before your first telephone or televideo intake appointment, please click the link below to download the one-page telehealth/treatment/billing consent form your should complete before your appointment.

CLICK HERE TO DOWNLOAD THE TELEHEALTH/TREATMENT/BILLING CONSENT FORM (1 page)

 

For the packet of forms for outpatient services, please click the link below to download the forms your should complete before your visit.

CLICK HERE TO DOWNLOAD OUTPATIENT FORMS (8 pages)

 

For the packet of forms for our FACE to FACE (PHP) program, please click the link below to download the forms your should complete before your visit.

CLICK HERE TO DOWNLOAD FACE TO FACE (PHP) FORMS (12 pages)

 

Release of Information Form

If you are requesting that we share your health records with another provider, you will need to complete an Authorization to Release Confidential Information form and return it to New Oakland. You can access the form by clicking the link below:

CLICK HERE TO DOWNLOAD THE AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION (1 page)