Forms
At the first appointment, you will be asked to fill out the New Client Intake Forms, Privacy Forms and What To Expect At Your First Appointment Form. These will provide our staff with medical and family history, including any sleep, dietary, injury and other health related issues. We will also assess how the child is coping as well as the parent(s). We would like to get a glimpse into a typical day in the client's life.
Specific Forms & Brochures
For your convenience, please download all three forms and print them. Bring the completed forms to your first visit. You may download them separately, or you may download the entire New Client Packet. Click here for download and email instructions.
- Client Intake Form:
- Client Intake - Secondary Insurance Form:
- Privacy Notice Forms:
- What To Expect At Your First Appointment Form:
- Authorization for Release of Information Form:
- New Client Packet (contains all of the above in one file):
- Outpatient Services Agreement for Collaterals
- Consent and Agreement for Psychological Testing and Evaluation
- Credit Card Payment Consent Form
- Assessments and Specialized Packets for Parents and Teachers:
- Login to this area with the user name and password provided by the staff of Agor Behavioral Health Services, Inc.
- Therapist Forms and Documents
- Login to this area with the user name and password provided by the staff of Agor Behavioral Health Services, Inc.
- New Hires
- New employees may login into our New Hire Information page to download all forms necessary to begin practicing with Agor Behavioral Health Services, Inc. Please contact the office for the appropriate Login Name and Password information.
- Brochures
- Agor Behavioral Health Services, Inc. Information Brochure
- Maintaining Mental Health in Older Adults Brochure
Downloading Forms
To download the files, click on the link and a new window will open.
- Word Format
- If you choose Word Format, you may choose to open the file or save a copy on your computer. Save it to a location where you can easily retrieve the file, such as your Desktop or in My Documents.
- You may type in your information into the Word file, save the file and then either print the pages or email to intake@doctoragor.com.
- PDF Format
- If you choose the PDF Format, the document will open in a new window. You will need to have Adobe Acrobat Reader installed on your computer to view the files in PDF Format. (Click here to download the FREE Adobe Reader.)
- Print the PDF file pages, write in your information and bring to your appointment.
Emailing Forms
You may choose to complete the forms on your computer. However, if you do decide to email your forms to us, please understand that information sent via email may not be confidential. If you email this information, you do so at your own risk. Forms may be sent to intake@doctoragor.com.
To email Agor Behavioral Health Services a completed form:
- Open your email program or login to your webmail account (such as Yahoo, Google, etc.).
- Attach your completed file as you would any other document. You will need to locate the file on your computer.