Integrative Behavioral Health Enrollment

Agreement to Receive Integrative Behavioral Health Program Services

Boro Clinic

As part of Boro Clinic's commitment to comprehensive patient care, we offer an Integrative Behavioral Health (IBH) Program to support mental and physical well-being through coordinated care.

Services Included:

Access to a care team that includes primary care physicians, behavioral health specialists, and other healthcare professionals, with the ability to contact the team by phone or other non-face-to-face communication methods (e.g., email).

Scheduled appointments with your designated care team member for behavioral health management.

Personalized care management, including:

Development of a comprehensive behavioral health care plan tailored to your needs, preferences, and goals.

Coordination of care across providers, including referrals and follow-ups after hospitalization, emergency visits, or specialist appointments.

Medication management and reconciliation for mental health-related treatments.

Access to community and home-based services for integrated care.

Terms and Conditions: I understand that participation in the Integrative Behavioral Health Program includes the above services and is designed to provide continuous and coordinated care.

I acknowledge that:

I may revoke this agreement at any time, effective at the end of a calendar month.

This program may include fees or copayments depending on my insurance plan, which I will be responsible for.

My designated provider may communicate with other treating professionals as part of my care coordination.

By signing this agreement, I designate Boro Clinic as my primary care provider for purposes of integrative behavioral health services. I consent to the coordination and communication of my health information electronically as part of this care.