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SBBH Intake Screening
This intake form is for prospective patients of Santa Barbara Behavioral Health who are seeking treatment. Answering some questions online will help us discover if we can serve you. If we can, you will also help us learn if you can use your health insurance to pay all or some of the costs. You will need your insurance card to answer some of the insurance coverage questions.

Please note that we are not able to treat patients through standard Medicare insurance.

(If you prefer to have our staff reveiw these questions with you instead of completing this online, please call the office at 805 681-0035.)

If you complete this form and receive the message that we are likely to be able to provide clinical services to you, we will process your information and call you back to schedule an initial appointment.

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