Patient Forms

New patients will need to fill out the Intake Questionnaire prior to the initial assessment. To make the process as smooth and efficient as possible, we provide this document as well as our Release of Information form as downloads right here on our website.


If you wish to complete the forms in advance, select the appropriate download link below and return the completed documents to our practice either in person or by fax. These forms are also available at the practice; however, filling them out in advance saves time.

If you are unsure which forms to fill out, don't hesitate to contact us.


Intake Questionnaire
JBH Intake Questionnaire, Newest Version[...]
Adobe Acrobat document [654.4 KB]
Authorization to Disclose Patient Information
Please fill out this form to send or receive your medical records. Make sure to include the recipient in detail, including where we need to fax, mail or email the records. This will ensure prompt arrival to either you or the facility or entity that is in need of your records. Due to the time it takes our staff to search, prepare, organize and transfer this paperwork quickly and efficiently, there is a fee that is due before each Medical Records request can be fulfilled. Please refer to our Fee Schedule under the "Appointments" tab at the top of this page to find the fee for this and other services that Jones Behavioral Health, Inc. offers.
JBH Medical Release Consent Form.pdf
Adobe Acrobat document [4.0 MB]

Office Hours


9:00a until 5:00p


9:00a until 2:00p



Our Location

114 Pleasant Home Road,

Suite A

Augusta, GA 30907


Office:  (706) 364-3209

Fax:      (706) 364-3259

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