Address

Phone:803.216.0850 Fax:803.216.0420

Phone:803.216.0850 Fax:803.216.0420

  • Home
  • About
  • Forms
  • Patient PORTAL LINKS
    • Portal Home Main Page
    • New/Existing Pt. Forms
  • Our Team
  • OWL Video
  • FAQ's
  • Audio Download
  • More
    • Home
    • About
    • Forms
    • Patient PORTAL LINKS
      • Portal Home Main Page
      • New/Existing Pt. Forms
    • Our Team
    • OWL Video
    • FAQ's
    • Audio Download
  • Home
  • About
  • Forms
  • Patient PORTAL LINKS
    • Portal Home Main Page
    • New/Existing Pt. Forms
  • Our Team
  • OWL Video
  • FAQ's
  • Audio Download

Specializing in the Strategic Integration of Behavioral and Medical Care

Specializing in the Strategic Integration of Behavioral and Medical Care Specializing in the Strategic Integration of Behavioral and Medical Care

Ensuring the individual attention they need.

Please send completed saved forms to appointments@barnabashealthcare.com

New Client Intake Paper (may require download)

Please attempt to complete these forms through our patient portal before using the pdf versions below. 

All new patients need to complete the Payment and Insurance Form as well as the applicable Intake Form. 

ADULT INTAKE (pdf)Download
ADHD INTAKE (pdf)Download
Child Intake Form Under Age of 10 (pdf)Download
Parent/Guardian of Adolescent Intake 11-17 Years Old (pdf)Download
Adolescent Intake Form 11-17 Years Old (pdf)Download

Consent Forms PACKET

Privacy Policy, No Show, Telehealth, Non Acute Care, Financial Policy in one document. 

Consent Forms Packet Adult (pdf)Download

Releases and Consent

Release of Information (pdf)Download
Controlled Substances Contract (pdf)Download
Consent to Treat a Minor (pdf)Download
Financial Policy Acknowledgement For Sign (pdf)Download
No Show Acknowledgment for Sign (pdf)Download
Non Acute Care Acknowledgement for Sign (pdf)Download
Privacy Practices Acknowledgement for Sign (pdf)Download
Tele-Health Informed Consent for Sign (pdf)Download

Virtual Care Forms and Information

Portal User Guide for Patients (pdf)Download
Televisit Consent (pdf)Download
CGM ELVI Patient Reference Guide (pdf)Download

Special Forms

* Required Payment and Insurance Form (pdf)Download
COT- Annual Pain Medication Screening Form (pdf)Download
Spinal Cord Stimulator Psych Clearance Forms (pdf)Download
Bariatric Pre-Surgery Psych Clearance Forms (pdf)Download
Humana Referral Form Prefilled- (pdf)Download
Mood Disorder Questionnaire (MDQ) (pdf)Download
Generalized Anxiety Disorder Questionnaire(GAD7) (pdf)Download
Patient Health Questionnaire (PHQ9) (pdf)Download
Safety Contract (pdf)Download
  • OWL Video

Barnabas Behavioral Healthcare, LLC

409 Evelyn Drive, Columbia South Carolina 29210

803.216.0850

Copyright © 2020 Barnabas Behavioral Healthcare, LLC - All Rights Reserved.

Portal Clinic ID P1727442