Consent for Treatment
I agree and consent to participate in behavioral health care services offered and provided by Pinnacle Behavioral Healthcare. I understand that I am consenting and agreeing only to those services that the above-named provider is qualified to perform within: (1) the scope of the provider's license, certification, and training; or (2) the scope of license, certification, and training of the behavioral health care providers directly supervising the services received by the patient. If the patient is under the age of eighteen or unable to consent to treatment, I attest that I have legal custody of the above named individual and am authorized to initiate and consent for treatment and/or legally authorized to initiate and consent to treatment on behalf of this individual.
◄ BACK
Secure Patient Login
View Practice Forms
Accessible Version
Integrated Patient Portal ©
WRS Health