ANN ARBOR CONSULTATION SERVICES

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  • Clinician Intranet
  • Office Intranet
  • Home
  • Forms
  • Resources
    • Tip Sheets
    • Ann Arbor Area and Internet Resources
    • Financial/Other Assistance
  • Clinician Intranet
  • Office Intranet

Download Client Forms

Note that all files are in PDF format; to display and print correctly, they must be opened in Adobe Reader. If you do not have the current version of Adobe Reader, you can download it for free from Adobe's website.

***Please do not print forms double-sided***

New Clients

Adult packet (18 or older)
Child/teen packet (under 18)

Abbreviated packets (for clients returning less than 6 months after discharge)


Adult abbreviated packet (18 or older)
Child/teen abbreviated packet (under 18)

Current Clients

Release of Information
Request for Document Completion
HIPAA Confidential Handling of PHI
HIPAA Accounting for Disclosures
Preferred Pharmacy Form
Consumer Handbook
Feedback Form
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