Attention New Patients:

All new patients please complete our “New Patient Packet” This convenient online form is for all providers at Chattanooga Behavioral Alliance.

Please note: The New Patient Packet submitted online is encrypted for your privacy

 

Printable PDf’s

Download, print, and fill out these forms if applicable

HIPAA Privacy Policies for reference only

PHQ-9 Depression questionnaire PDF
HIPAA RELEASE OF INFORMATION FORM
hipaa privacy policies (READ ONLY)
 

Submit Online

Currently our therapists have a full client load and are not accepting NEW therapy /counseling patients at this time

Note * We require a referral from your primary care or counselor in order to coordinate care with others to provide the best behavioral healthcare possible

Online New Patient Packet
Annual Update Form (Current Patients)
insurance update form

For Referring Providers

Bariatric Testing Referral Form
Behavioral Health Referral Form
Learn more