Forms and Resources

Release of Information

Child/Adolescent Intake Forms

Extensive information about mental health diagnosis and treatment available at:

Resources

Brunetti Consulting

Psychological Services

National Institute of Mental Health

Adult Intake Forms

Additional Forms

Adult ADHD Rating Form

Teacher ADHD Rating Form

New Patient Forms

If you are a new patient, you can save time at the beginning of your initial appointment by completing the new patient forms at home. Download and print out forms below (you will need Adobe Reader to open the files). Fill out the forms and bring them to your first appointment.

Brunetti Consulting
Psychological Services
21308 John Milless Drive, Suite 101B
Rogers, MN 55374-4875
763-428-4060 office
763-428-1711 fax

Emergency: If you are in a clinical emergency, call 911 or go to your local emergency room.

Residents of Benton, Stearns, Sherburne and Wright counties can contact the Four County Crisis Response Team at 800-635-8008.

Residents of Hennepin County can contact the mobile crisis team: 612-596-1223 (adults) or 612-348-2233 (children)