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Client Forms

​​​Below are the forms that you will need for your appointment at the ​Boys Town South Florida Behavioral Health Clinic. The first two groups of ​forms are mandatory. If you have any ​questions, please contact 561-612-6056.

Forms

New Client Forms to Complete and Bring With You (Mandatory)

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Agreement and Consent for Services

Client ​Information Sheet

Email Information Form

Pretreatment Questionnaire

Pediatric Symptom Checklist

Authorization for Release of Information to Primary Care Provider

New Client Information and Notices (Mandatory)

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Client Rights and Responsibilities

Notice of Privacy Practices

Office Policy

Payment Policy

 Additional Consent and Release Forms (When Needed)

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Authorization to Release of Information to Other

Consent for Another Adult to Participate