be_ixf;ym_202412 d_03; ct_50
be_ixf; php_sdk; php_sdk_1.4.26
https://www.beaconhealthsystem.org/beacon-medical-group/forms/
https://www.beaconhealthsystem.org/beacon-medical-group/forms/
For Patients
Physician Recruitment
Providers
Beacon
For Patients
Physician Recruitment
Providers
Beacon
Beacon Medical Group Forms
ADHD Assessment Follow-up for Parents
(PDF)
ADHD Assessment Follow-up for Teachers
(PDF)
ADHD Initial Parent Letter and Assessment
(PDF)
ADHD Initial Teacher Letter and Assessment
(PDF)
ADHD Menu of Rewards
(PDF)
Authorization for Disclosure of Information
(PDF)
Authorization for Disclosure of Information – Spanish
(PDF)
Consent to Treat Minor
(PDF)
Consent to Treat Minor – Spanish
(PDF)
Consent for Treatment HIPAA
(PDF)
Consent for Treatment HIPAA – Spanish
(PDF)
HIPAA Consent for Patient Information Release
(PDF)
