Resources

Please download and complete the following intake documents prior to attending your first appointment at Inspire Behavioral Health. If you have any questions regarding these documents, please do not hesitate to contact one of our staff partners at 734.929.4741.

Required Intake Paperwork:

ADULT CLIENT QUESTIONNAIRE

ADOLESCENT QUESTIONNAIRE FOR CLIENT

ADOLESCENT QUESTIONNAIRE FOR PARENT

CONSENT FOR TREATMENT OF A MINOR (10-13)

CONSENT FOR TREATMENT OF A MINOR (14-17)

COUPLES QUESTIONNAIRE

DEMOGRAPHIC FORM

INFORMED CONSENT FOR TREATMENT

KAREO CARD ON FILE AUTHORIZATION

MEDICAID BENEFICIARY

RELEASE OF INFORMATION – GENERAL

RELEASE OF INFORMATION – LEGAL

RELEASE OF INFORMATION – PHYSICIAN

RELEASE OF INFORMATION – PSYCHIATRIST/THERAPIST

RELEASE OF INFORMATION – SCHOOL

SELF-PAY OPT-OUT

TELEHEALTH CONSENT

TELEHEALTH CONSENT FOR A MINOR

VERIFICATION OF BENEFITS