Admissions & Treatment Forms

Accepting that you need treatment is a big step and we don’t want to start off by overwhelming you with long procedures and paperwork to fill out. Dr. Sterling tries to keep the admissions process as simple as possible so that you can focus on what you came to do: heal.

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Use the links below to print and fill-out patient forms at your own pace:

• Treatment Records Consent Form

• Substance Use History Form

• Patient History Form

• Pain Assessment Scale

• HIPPA Privacy Form

• Demographic Intake Form
  Buprenorphine-Naloxone Treatment Agreement

• Patient Health Questionnaire

• Adult ADHD Self-Report Scale Symptom Checklist

• Agreement for the Treatment of Alcohol Use Disorder

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