Forms

The following forms can be downloaded for your convenience. All forms are in PDF format and require Adobe Acrobat Reader, which may already be included in your browser. Please call us if you have any questions completing the forms (310) 276-4003. Forms can be faxed to (310) 276-4073 or emailed to info@bowmanmedicalgroup.com.

New Patients

Patient Eval Forms

Adolescent Intake FormsFor children under 18 years of age.

Treatment Of A MinorAuthorization from parent or legal guardian.

Consent For PsychotherapyFor patients that will be coming in for therapy.

Other Office Forms


Credit Card AuthorizationFor a credit card to be on file for payments.

Release For Financial DataFor an additional responsible party paying for the appointments.

Insurance VerificationNecessary information needed to verify medical benefits and properly submit claims.

Release of Information for Medical Data – Authorization for any medical information to be released to an individual, agency, company, or institution. 

Privacy Policy - To ensure the private and confidential handling of medical information for all patients. 

Medical Questionnaires


Depression Screening Form

ADHD Rating Scale (Adult)

ADHD Rating Scale (Adolescent)

BMG Self-Care Log

Bipolar Disorder Rating Scale

Opioid Withdrawal Scale

The Montgomery-Asberg Depression Scale (MADRS)

Obsessive Compulsive Disorder Self Test

A PMDD diagnosis requires prospective daily monitoring of symptoms for at least two consecutive months. To distinguish the disorder from PMS, use this Daily Record of Severity of Problems (DRSPP)

Epworth Sleepiness Scale (ESS)