Patient Forms
Thank you for choosing The Center for Behavioral Medicine as your provider for
behavioral health services. Please complete and return the necessary
paperwork to our main office (in Palo Alto prior to October 1st, 2021, or in Santa Rosa on or after October 1st, 2021)
1260 North Dutton Avenue Suite 100 Santa Rosa, CA 95401 , at least two business days prior
to your first appointment.
New patients should submit the following questionnaires/forms:
- Adult Intake Form (if applicable)
- Child/Teen Intake (if applicable)
- Current Medication Record
- Consent to Release Information
If you have any questions about our questionnaires/forms, please feel free to contact Angelica, at our main office by calling (650) 856-0406.
