Image

Psychiatry and Counseling Patient Forms

 

New Patient - Psychiatry (M.D.) and Counseling

This form is required to start seeing a River Oaks Health clinician.

 

Current Patient Appointment Request

Current patients please use this form to schedule your next appointment.

 

Authorization for Disclosure of Health Information

This form is required for sending any medical information from River Oaks Health to another entity.

 

Referral to River Oaks Health

This form is for other healthcare providers to make referrals to River Oaks Health.

 

Update Patient Information and Insurance

This form is required for updating patient information.

 
 
Image

Employee Assistance Program (EAP) - Patient Forms

The forms below are ONLY for EAP patients. Check with your Employer Human Resources Department to see if your company has our EAP services.

 

Employee Assistance Program (EAP) - New Patient Registration

This form is required for all new EAP Patients.

 

Employee Assistance Program (EAP) - Office Policies and Statement of Understanding

This form is required for all new EAP Patients.

 

Employee Assistance Program (EAP) - Mandatory Referral Information Form

This form is required for all new EAP Employer Mandatory Referral.  Must be completed by the Employer and Employee.

 
 

EAP Employer Count Reporting

This form is used by employers to report active EAP covered employee counts.