Forms
Telehealth forms help healthcare practices schedule virtual appointments with patients and collect medical records, informed consent, fee payments, and other important health data online. The forms allow us to securely gather important patient information through the website. Simply choose a form from the list, complete it, and send it back to us via fax at 1-800-853-7998 or email it to: admin@GYGCounseling.com
- GYG Consent Packet.pdf
- After Hours Crisis Response Services Form.pdf
- Cancellation No Show Late Arrival Policy.pdf
- Consent for Services Form.pdf
- Consumer Choice Form.pdf
- Consumer Rights Acknowledgement Form.pdf
- Court Appearances Subpoenas and Expert Witness Testimony Policy.pdf
- Credit Card Authorization Form.pdf
- Fees and Insurance Form.pdf
- Medical Release Form.pdf
- Notice of Privacy Practices.pdf
- Release of Information Form.pdf
- Right to Confidentiality Form.pdf
- GYG-Referral-Form.pdf