Pathways Mental Health Services
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​Pathways Telehealth Clinic and Wellness Program Forms:
Please complete the 3 forms (Adult or Child & Adolescent demographic, Informed Consent, and HIPAA & Privacy Act) in order to become a new patient of Pathways MHS Telehealth or Pathways Wellness Program
​
click here for the telehealth forms - fillable online

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​We cannot process your intake paperwork until we received all of the required forms and a copy of your insurance card and picture ID. You need to put your SIGNATURE on all of the required fillable forms​.
​
​After completing the fillable forms, please fax  a copy of your photo ID and insurance card to (360) 846-1722 for the Telehealth Clinic. Once we have all forms and have verified your insurance coverage, we will call you to schedule an initial assessment.
​
Notice: Due to Washington health care laws, the ROI form should be completed by clients age 13 and up if a parent or other party will need to communicate with us about scheduling or other information.

click here to go back to the main forms page
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  • Home
    • Staff
    • Providers
    • Satisfaction Survey
  • Clinics
    • Lacey Clinic
    • Longview Clinic
    • Telehealth Clinic >
      • Telehealth Hours
      • Telemedicine >
        • FAQ - Telehealth - Self Pay
        • FAQ - Telehealth - Using your Insurance
    • Telehealth International
  • Mental Health Counseling Services
    • Anger Management Inquiry
    • Co-occurring Disorders Treatment >
      • Co-occurring Disorders Group
    • Mental Health >
      • Outpatient Services
      • Group Therapy
      • Play Therapy
    • Trauma Focused Treatment
  • Addiction Services
    • DOT - SAP Services
    • Outpatient Services
    • Relapse Prevention Therapy
    • Gambling Services
  • Insurance
    • Accepted Insurance
    • Accepted EAP
  • Online Testing & Screening
  • Training
  • Patient Portal
  • Therapy Interest Form
  • School Services