Lake Cook Behavioral Health
  • Services
    • Adults
    • Children/Adolescents >
      • Play Therapy
      • Social Anxiety
      • Impulsive behavior
    • Couples Therapy
    • Family Counseling >
      • Family Therapy
    • Seniors >
      • Psychotherapy for Seniors
    • Mental Health Services >
      • Addictions
      • Anger Management
      • Anxiety
      • Bipolar Disorder
      • Depression
      • Eating Disorders
      • PTSD
      • Women's issues
  • Our Staff
    • Arlington Heights
    • Northbrook
    • Evanston
    • Naperville
    • Inverness
  • Contact Us
    • Locations
    • Request Appointment
    • Staff Directory
  • Payments
  • Forms
  • Careers
  • Services
    • Adults
    • Children/Adolescents >
      • Play Therapy
      • Social Anxiety
      • Impulsive behavior
    • Couples Therapy
    • Family Counseling >
      • Family Therapy
    • Seniors >
      • Psychotherapy for Seniors
    • Mental Health Services >
      • Addictions
      • Anger Management
      • Anxiety
      • Bipolar Disorder
      • Depression
      • Eating Disorders
      • PTSD
      • Women's issues
  • Our Staff
    • Arlington Heights
    • Northbrook
    • Evanston
    • Naperville
    • Inverness
  • Contact Us
    • Locations
    • Request Appointment
    • Staff Directory
  • Payments
  • Forms
  • Careers
Picture
​These forms are for the use of new or existing clients and can be used to help the registration process, or give permission to discuss with other parties.

New Client Required Forms:
  • New Client Registration Form  new_client_registration_form.pdf
  • ​Insurance Authorization  insurance_authorization.pdf  
  • Consent for Treatment Form consent_for_treatment.pdf
  • Handling Confidential Information confidential_info.pdf
  • Client Questionnaire client_questionnaire.pdf
  • Payment Agreement payment_agreement.pdf

If Applicable:
  • Child/Adolescent Health History

Other Forms:
  • Clinical Release of Information


Proudly powered by Weebly
Photo from thelittleone417