Timko Behavioral Healthcare

Adult Intake Packet

• Intake/History 

• Confidentiality

• Payment Responsibility

• HIPAA

• Release Authorization

Child & Adolescent Intake 

• Intake/History

• Confidentiality

• Payment Responsibility

• HIPAA

• Release Authorization

• Child Symptom Checklist

Please complete all forms prior to your first session or arrive 30-45 minutes before your appointment.