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Resources for Healing


 

Download Forms & Policies

(PBH) Arbitration Agreement (pdf)Download
(PBH) Blue Cross and Blue Shield (pdf)Download
(PBH) Consent for Telehealth Consultation (pdf)Download
(PBH) COVID-19 and Variants Liability Release Waiver (pdf)Download
(PBH) Credit Card Automatic Charges (pdf)Download
(PBH) Dispute Charges (pdf)Download
(PBH) Form Completion Policy (pdf)Download
(PBH) Individual Intake Questionnaire (pdf)Download
(PBH) Informed Consent for Treatment (pdf)Download
(PBH) Insurance Information (pdf)Download
(PBH) Minor Consent for Treatment (pdf)Download
(PBH) Notice of Privacy Practices (pdf)Download
(PBH) PBH Inc. Billing Service (pdf)Download
(PBH) Please upload your insurance card (pdf)Download
(PBH) Practice Policies (pdf)Download

Download Forms & Docs

Billing & Service Info (pdf)Download
Client Therapy Forms (pdf)Download
Upload Docs & Insurance (pdf)Download

Access Spanish Forms Here

(Spanish) Acuerdo de Arbitraje (pdf)Download
(Spanish) Acuerdo de copago y deducible del seguro (pdf)Download
(Spanish) Anthem Blue Cross and Blue Shield_Spanish (pdf)Download
(Spanish) Aviso de prácticas de privacidad (pdf)Download
(Spanish) CONSENTIMIENTO - MENOR (pdf)Download
(Spanish) CONSENTIMIENTO DE TELESALUD (pdf)Download
(Spanish) Consentimiento fundamentado para psicoterapia (pdf)Download
(Spanish) Consentimiento para telesalud (pdf)Download
(Spanish) Cuestionario de Salud (pdf)Download
(Spanish) Información del seguro (pdf)Download
(Spanish) Servicio de facturación de PBH (pdf)Download
(Spanish) Subir documentos y tarjeta de seguro (pdf)Download
(Spanish) COVID (pdf)Download

Patient Resources & Forms

External Provider Handbook 2021 (pdf)Download
Set up Lucet Account (pdf)Download
CALM Handout (pdf)Download
Couples Therapy One Sheet (pdf)Download
External Provider Scheduling and Documentation Refresher (pdf)Download
Ginger Handout (pdf)Download
KP Branded Center for Healthy Living (pdf)Download
KP Branded Regional Mental Wellness (pdf)Download
KP Neuropsych External providers (pdf)Download
KP OSM information on FIC and TPI (pdf)Download
KPEP Couples counseling Referral_2021 (pdf)Download
KPEP Group Referral_2021 (pdf)Download
KPEP Medication Evaluation Referral_2021 (pdf)Download
Mystrength handout (pdf)Download

Therapy Videos

Explore Therapy & Support
View Therapy Videos

Earnings Comparison: Private & County

Private Practice vs Ventura County vs LA County Earnings (pdf)Download
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