JW
James Wright
Active
MRN: MRN-100478·DOB: 1988-07-22 (Age 37)
LOC: PHP / IOP Program
Program: Behavioral Health
Clinician: David Washington
Allergies:
Codeine
Insurance: Verified
Pending Forms
0 pending
No pending forms.
Completed Forms
3
HIPAA Acknowledgment
Notice of Privacy Practices acknowledgment and signature
Completed 2026-02-15 · Signed by Patient
Completed
Treatment Consent
Consent for behavioral health treatment
Completed 2026-02-15 · Signed by Patient
Completed
Medication Consent
Consent for medication administration
Completed 2026-02-15 · Signed by Patient
Completed