Northwest Behavioral Medicine
Northwest Behavioral Research Center

About Us

Forms and Information for Patients

We Are Not Providers For Blue Cross Silver Pathways (The Obamacare Health Insurance Exchange)

We are not currently accepting new patients under 21 years of age for medication management. Referrals available for counseling for under 21 years.

New Patients

Before your first visit, please make sure you have reviewed and filled out the following forms:

New Patient Form

Our Practice Policies and Procedures



These forms are our registration package and are in Adobe Acrobat (.pdf) format. If you do not already have the Adobe Acrobat Reader, you can download it free of charge from the Adobe web site.

Help Your Doctor with Your Medication History: Go to

 All New Patients Must Confirm New Appointments By Phone or Email Within 24 Hours Before Appointment Or Appointment Will Be Cancelled.

Authorization for Release of Medical Information

Please download and fill out the appropriate form pertaining to your request.

Authorization for Release Information TO NBM

Authorization for Release Information FROM NBM