Wp.options.org

Options Counseling AUTHORIZATION TO USE AND DISCLOSE …

Options Counseling and Family Services Location: t My information may be released to or from the following Agency or Name of Individual … See more

Actived: 6 days ago

URL: https://wp.options.org/3862-2/?esigtodo=esigpdf&did=dea609cd4797e0ff9d0ebb5b3bcf031b9930cf75

BEHAVIORAL HEALTH INFORMATION

WEBDocument ID: 1d88cf5d13ca6af38826e63cd579caf418e09c3c Generated on: May 11, 2020 Signed On: https://wp.options.org/ BEHAVIORAL HEALTH …

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INFORMED CONSENT FOR TREATMENT

WEBWashington County Health and Human Services 155 N. First Avenue, MS #70, Hillsboro, OR 97124 Phone: (503) 846-4554. By initialing I agree that I have read and understand …

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Client Intake Sheet

WEBDocument ID: 18878fe1c48d8620cce6681289f9225a894179e1 Generated on: November 25, 2020 Signed On: https://wp.options.org/ Alternate - Mailing Address: …

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Behavioral Health Checklist

WEBClient #:_____ BEHAVIORAL HEALTH INFORMATION Rev. 12/01/16 What services are you seeking? _____ Therapy _____ Med Management _____ Skills Training

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Client Intake Sheet

WEBRevised 11/2018 Race (Please check from the following): White American Indian Black/African American Alaskan Native Asian

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VSee for Clients on Windows PC

WEBVSee for Clients on Windows PC Please make sure your computer has: a webcam, speakers and a microphone. From Chrome go to: …

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I authorize Options Counseling & Family Services to use and …

WEBRevised 09/2019 Options Counseling and Family Services of Oregon, Inc AUTHORIZATION TO USE AND DISCLOSE PROTECTED HEALTH INFORMATION …

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INFORMED CONSENT FOR TREATMENT

WEBIn Washington County at (503) 846-4554 or in writing at: Washington County Health and Human Services 155 N. First Avenue, MS #70, Hillsboro, OR 97124. 1 A …

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Physical Health & Medical History

WEBClient #:_____ Revised June 2017 Physical Health & Medical History Please answer the following questions as accurately and completely as possible.

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Notice of Privacy Practices Confidentiality

WEBClient #:_____ ACKNOWLEDGEMENT OF POLICY Acknowledgement Options Counseling & Family Services of Oregon Rev. 03/2019

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Client Intake Sheet April 18

WEB3 Revised 3/2018 Race (Please check from the following): White American Indian Black/African American Alaskan Native Asian Native Hawaiian/other Pacific

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Resources – Portland metro area

WEBPortland - Southwest. First Baptist Church 909 SW 11th Ave Portland, OR 97205 503-228-7465 Food boxes available on Monday & Thursday, 2 pm - 4 pm.

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Historial médico y de salud

WEBCliente n.º:_____ Revisado junio del 2017 Historial médico y de salud Por favor, conteste las siguientes preguntas con tanta precisión y detalle como sea posible.

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