Staff photo

Pre-Admission Forms

Prior to admission at BBRC, all potential clients must have the following forms filled out completely:

  • Face Sheet containing patient contact and insurance information
  • List of Previous Doctors and Physicians
  • Patient's Authorization to Release and Disclose Information to BBRC
  • Acknowledgement of Receipt of HIPPA Notice of Privacy Practices


    • The pre-admission forms can be downloaded here.

    After completing the forms, the potential client should fax or mail them to BBRC for review by the intake coordinator. Once the review process is complete, BBRC will contact the potential client.