Forms
Please download, print, complete and sign all the required forms:

Required for all new patients:
BPS Adult Intake Packet Download PDF Download PDF
BPS Child Intake Packet Download PDF Download PDF
BPS Teacher and Other Form Download PDF Download PDF

Required for Medicare patients:
BPS Medicare Waiver Download PDF Download PDF
BPS Medicaid Waiver Download PDF Download PDF
BPS Tri-care Waiver Download PDF Download PDF
Workman's Compensation Waiver Download PDF Download PDF
Other Insurance Waiver Download PDF Download PDF

Required for all Suboxone patients:
BPS – Suboxone Intake Packet Download PDF Download PDF
  Insurance
We accept Blue Cross/Blue Shield Insurance, Allegiance, as well as others. Please inquire about other insurances that may be accepted.

Missed Appointments
You will be billed in full for any appointments that you miss or cancel without 24-hour notification before the appointment.

Confidentiality
What is discussed will remain confidential unless you authorize the office to share that information with another person. However, if a person is in danger of hurting themselves or another person, the law requires us to take steps to protect those involved. We are also obligated to report to the proper authorities any suspected neglect or abuse.
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