Forms - Beehive Comprehensive Clinic

Mind + Body wellness for the whole family

801-252-6116

801-508-2787

[email protected]

Business Forms:

HIPAA (Privacy Policy), Consent to Treat and Financial Agreement: http://bit.ly/BeehiveForms
Release of Information – From another provider TO Beehive: http://bit.ly/BCCrecords
Release of Information – Beehive to another provider: bit.ly/BCCrelease

Mental health screening forms:

PHQ-9 (Depression): http://bit.ly/BeehivePHQ-9
GAD-7 (Anxiety): http://bit.ly/BeehiveGAD-7

MDQ (Mood Disorder Questionnaire): http://bit.ly/BCCMDQ
CBQ (Child Behavioral Questionnaire): http://bit.ly/BCCCBQ

ADHD:

Wender Scale: http://bit.ly/BCCWender

Autism
M-CHAT: http://bit.ly/BCCMCHAT

PANDAS:

PANDAS Intake: http://bit.ly/BCCPANDAS
PANDAS Follow Up: http://bit.ly/FollowPANDAS

Children’s OCD screening tool
CY-BOCS Intake: http://bit.ly/CY-BOCS
CY-BOCS Follow Up: http://bit.ly/FollowCY-BOCS

Adult OCD screening tool
Y-BOCS Intake: http://bit.ly/Y-BOCS
Y-BOCS Follow Up: http://bit.ly/FollowY-BOCS

Tic Severity Scale

YGTSS Scale: http://bit.ly/YGTSS

Sleep Studies

Sleep ring agreement: https://bit.ly/BeehiveSleep

Sleep Apnea Screening https://bit.ly/BeehiveOSA