New Client / Intake Packet
Completed before or at your first appointment. Our office will send it to you when your appointment is scheduled.
Document to be supplied by our office
Client Forms
Paperwork, all in one place.
These are the documents clients of HopeRise are asked for. Our office will send you everything you need when your first appointment is scheduled.
Referral Form
For professionals and organizations referring a client. Until the printable form is posted here, use the referral request form on our Referrals page.
Document to be supplied by our office
Release of Information
Authorizes us to share information with a provider, school, or agency you name.
Document to be supplied by our office
Client Rights
Your rights as a client of HopeRise. Call our office and we will provide a copy.
Document to be supplied by our office
Notice of Privacy Practices
How your health information is used and protected.
Document to be supplied by our office
Appointment & Payment Policies
Scheduling, cancellation, and payment expectations.
Document to be supplied by our office
Request a document
Call (216) 487-1316 or email info@hoperisementalhealth.com and we'll send the form you need. Please don't email completed forms containing health information — bring them to your appointment, fax them to (216) 455-7520, or ask us for a secure option.
Send us your current PDFs (intake packet, client rights, privacy practices, release of information, policies) and we'll publish them here as downloadable links. We won't create clinical or legal documents on your behalf.
In a crisis? Call or text 988 for the Suicide & Crisis Lifeline, or call 911 in an emergency. Our office, website, and forms are not emergency services and are not monitored around the clock.