downloadable Forms

Adult Patient Forms

HIPAA Notice – Notice of Privacy Practices

Medical History Form (English)

Medical History Form (Spanish)

Consent For Treatment Form (English)

Consent For Treatment Form (Spanish)

Walk-In Evaluation Form (English)

Walk-In Evaluation Form (Spanish)

Employment Application Packet

Background Consent Form

Background Investigation Disclosure

Fair Credit Reporting Act Summary

Remedying the Effects of Identity Theft

Application for Employment

Insurances Accepted

We accept most PPO/EPO/Work Comp insurance plans. If you have any questions about our accepted insurance plans, please contact our intake department at (661) 617-1182 or click the button below.

Referral Scripts

If you need TERRIO referral scripts for adult or pediatric therapy you can print them individually here or let us know and we can deliver a pad to you.