Client Forms

Please Note: We are not a provider with Medicaid.

Use the following forms to submit information to EBS Children's Institute. You can either fill it out online or download and print the PDF and bring it to us. If you choose to fill out a form online, please know that we take your security and privacy very seriously. Online forms are hosted on EBS's secure, HIPAA-compliant server. Please call or email us if you have any questions.

Step 1

Client Intake Paperwork

Complete Online
Download/Print



Step 2

Client Bill of Rights


Complete Online
Download/Print



Step 3

Please complete all documents in this section that pertain to the services your child will be receiving.