top of page

New Patient - Child/ Minor Patient Forms

At BCCNJ we hold your privacy sacred.  At the same time, it is often helpful for us to be able to speak with other providers, family members, and teachers to best help you and your family.  If you would like your clinician to speak with someone about your child’s treatment please complete and sign the consent form.​​​
New patients, please fill out the paperwork below. This will save time at our first visit. We look forward to meeting you.
​
​Click on the blue links below to download the needed forms
Authorization For Treatment - Child/Minor
 
Child/Minor Consent Form
 
Child/Minor Intake Form​​
 
H.I.P.A.A.​​ Privacy Form
bottom of page