iMind Mental Health and Wellness LLC

(731) 300-0810

65 Murray Guard Dr, Jackson, TN 38305

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Forms

Adult Forms

  • Card on File Authorization Form
  • Intake Form
  • Controlled Substance Agreement
  • Patient Financial Agreement
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  • HIPPA Release Form
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Minor Forms

  • Children and Youth Assessment
  • Minor Consent to Treat
  • Card on File Authorization Form
  • Controlled Substance Agreement
  • Patient Financial Agreement
  • No Show Cancellation Policy
  • Tennessee Release of Information
  • Telehealth Notice
  • HIPPA Release Form
  • Medical Records Release

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iMind Mental Health and Wellness LLC

Phone: (731) 300-0810 Address: 65 Murray Guard Dr, Jackson, TN 38305

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