Forms

For Parents

SBH Parental Consent Form 2023-24

SBH Parental Consent Form 2023-24 (Spanish)

SBH Parental Consent Form 2023-24 (French)

NYS Release of Medical Records

Summer Program Flyer

Summer Program Flyer (Spanish)

Patient Satisfactory Survey

Patient Satisfactory Survey (Spanish)

MHHC MH Referral Fillable Form (Dec 2019)

NYC DOC School Year 2023-24 Calendar

For Students

SBH Parental Consent Form 2023-24

SBH Parental Consent Form 2023-24 (Spanish)

SBH Parental Consent Form 2023-24 (French)

NYS Release of Medical Records

Summer Program Flyer

Summer Program Flyer (Spanish)

Patient Satisfactory Survey

Patient Satisfactory Survey (Spanish)

For Staff

Allergies/Anaphylaxis Medication Administration Form

Allergies/Anaphylaxis Medication Administration Form (Spanish)

Asthma Medication Administration Form

Asthma Medication Administration Form (Spanish)

Behavioral Health Referral Form

General Medication Administration Form

General Medication Administration Form (Spanish)

Request For Provision of Medically Prescribed Treatment (Non Medical)

Request For Provision of Medically Prescribed Treatment (Non Medical) (Spanish)

Seizure Medication Administration Form

Seizure Medication Administration Form (Spanish)

Diabetes Medication Administration

Diabetes Medication Administration (Spanish)