Forms

Woman using laptop at home at night while sitting at her kitchen table

As a new patient of Bridgepoint, we’ve listed a number of forms for your convenience. Following your initial call with our office, feel free to complete the recommended forms prior to your first visit:

Additional Clinical Symptoms (Dr. Patel and Gaelle Patients Only)
Clinical Assessment
Annual Consent & Authorization
Controlled Substance Agreement
Financial Responsibility Form
Card on File Consent Form

Form Fee Policy
Patient Demographics
New Patient Referral
Office Policies Form
Payment Policy Form
Release of Information Form

Start Your JourneyContact Us!

Complete this form so we can assist with your mental health journey.