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California Center for Behavioral Health
925 Ygnacio Valley Road, Ste 205, Walnut Creek, CA 94596 · (925) 289-9022 · Fax (888) 965-0556

Consent to Electronic Communication

I authorize CCBH to communicate with me by one or both of the methods below. Each section can be opted into independently. Methods I do not authorize will not be used.

Not for emergencies. In a medical emergency, call 911, or call or text 988 (Suicide and Crisis Lifeline). Do not use text or email for emergencies or for any time-sensitive clinical matter.

A. Text Message (SMS)

B. Email

Your Information & Acknowledgement