Patient Forms

New Patient Forms

If you are a new patient and have been registered online or by phone and directed to this page, please tap the appropriate button below. Completing this prior to your appointment is required. If you have not yet registered with SBBH, please tap the Get Started button on this page or call our office (805) 681-0035.

Request to Release Information

To manage the optional transfer of your protected health information, make your request below. 

For patients requesting records from other clinicians to SBBH

Authorization for Release of Medical or Mental Health Information | En Español

Alternatively, if you are the patient’s guardian:
Form | En Español

For patients requesting SBBH to send a copy of their records:

Authorization for Release of Medical or Mental Health Information | En Español

Alternatively, if you are the patient’s guardian:
Form | En Español

Authorization for Third Party Appointment Scheduling

To authorize payment on behalf of a patient, see options below.

If you are willing to guarantee payment for the exceptional situation in which a third party is making an appointment for a patient:

Authorization for Third Party Appointment Scheduling | En Español

Complete our simple intake form to see if your insurance plan covers SBBH services