Promoting positive change
Promoting positive change

Patient Portal to Get Started

To request an appointment or once your appointment has been scheduled, new patients will need to fill out some forms before therapy can begin. To make the process as smooth and efficient as possible, connect to our confidential, HIPAA compliant, patient portal by clicking " CBTS MYIO Patient Portal"and enter your  information. If you have any questions, please do not hesitate to call.  Thank you

 

Mood check-in before and Mood re-evaluation after session. Therapist evaluation sheet
Before and after mood check and evaluation of the therapist and therapy session. These forms have been found to improve the outcome of patients who complete these throughout their treatment.
Individual Before and After, version 20[...]
Adobe Acrobat document [599.8 KB]
Patient Rights to Confidentiality
This is for your reference.
HIPAA NOTICE-PATIENT.pdf
Adobe Acrobat document [202.2 KB]
Telemental Health Services Informed Consent
Informed Consent-Covid Protocol-CBTS.pdf
Adobe Acrobat document [287.0 KB]
Additional Agreement for Exposure Treatment
For patients who have been instructed by their therapist to complete
Exposureadvisementform.pdf
Adobe Acrobat document [430.0 KB]
Permission to contact another service provider
This is for all patients who are receiving/ or have received mental health/healthcare from other providers that may be needed to contact by your therapist.
Consent for Release of Informationchecke[...]
Adobe Acrobat document [363.8 KB]
Patient Update
For returning patients
Patient Update Questionnaire (PUQ).pdf
Adobe Acrobat document [718.8 KB]
Telemental Health Services Informed Consent
Informed Consent-Covid Protocol-CBTS.pdf
Adobe Acrobat document [287.0 KB]
Parent Agreement for treatment of their Child (under 18 years)
Child Advisement.LA.fill - Copy.pdf
Adobe Acrobat document [217.1 KB]
Consent to Release of Information
This will allow your therapist to have contact with other treating clinicians to help insure the most effective treatment.
Consent for Release of Information.LA.pd[...]
Adobe Acrobat document [366.4 KB]

Where to Find Us

Cognitive Behavioral Therapy Services
5650 El Camino Real
Suite 224
Carlsbad , CA 92008
Phone: 760-730-0521 760-730-0521
Fax: 760-730-0581
E-mail Address:

Office Hours

Monday-Friday

8:30 am - 6:30 pm

Patient Forms

New patient? After you set up your appointment, forms will be sent to you by email or through the postal service.  The forms on our website are also avaialble as a thrird option after your appointment has been made.

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