Intake Forms

Here you'll find your intake packet to get started as a client at Networks. The links below will bring you to the intake forms.

Required Forms

These forms will need to be completed for all new clients. We appreciate your taking the time to fill them out and help us understand your needs.

1 - Informed Consent

2 - Clinical History

3 - Disclosure Confirmation

4 - Insurance Card Upload

Additional Forms

You may need to complete other forms as requested by your provider. You won't need to complete these unless your provider asks for them.

5 - Child Addendum

6 - Medical Addendum

7 - Telehealth Consent

8 - Release of Information

9 - Email Authorization

10 - File Upload

Paper Forms

If for some reason you can't complete your form online with the links above, please discuss with your provider.

If necessary, our old forms can be accessed here to be printed and completed.