I hereby voluntarily request and authorize Generations Family Health Center, Inc. Behavioral Health Department to render the psychiatric services listed below, as clinically appropriate, to myself or my child.
and Medication management
are Coordination/Care Facilitation
(such as referrals to community
programs, insurance or other entitlement assistance, etc)
While receiving services in the Behavioral Health Department a treatment plan will be created that outlines treatment goals, discharge criteria, frequency of services as well as interventions. These will be reviewed on a routine basis.
Upon your written request, information regarding professional education and experience of the treating provider will be made available.
The Generations Behavioral Health Department does not participate in Research, Experimentation or Clinical Trials.
I understand that I have the right to question or refuse any treatment at any time.