Client Forms

Intake

Individual adults should complete the adult intake form. For families, couples, partners/spouses, each individual should fill out an adult intake form.

Adult Intake Form

Child Intake Form

For instructions on completing an intake form for children and adolescents, please contact our clinic at 844-573-3146.

Consent Forms, Client Rights & Responsibilities, HIPAA Notice

• Cohen Clinic General Consent
• Telehealth Consent
• Consent to Release Information to Cohen Veterans Network
• Penn Patient Bill of Rights & Responsibilities
  Click here for translations of the Penn Patient Bill of Rights.
• Cohen Clinic Client Rights & Responsibilities
• HIPAA Notice of Privacy Practices