INTAKE AND DISCLOSURE FORMS

Please download both the BPS Intake and BPS Disclosure forms.

Fill out and sign both forms. Print out the forms along with a copy of your insurance card front and back plus a photo ID. Email or fax the scanned signed forms and ID information to:

Email - bps@buckpsy.com

Fax - 303-750-5309

DOWNLOAD BPS INTAKE FORM

DOWNLOAD BPS DISCLOSURE FORM

 

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