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Forms

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General Counseling Forms

** All General Counseling Services will require the following forms to be completed as well as the forms listed under each service:

Required Forms:

Financial Information and Agreement
Informed Consent for Therapy
Notice of Privacy Practices

Child Counseling Age 0-12

Child Client Information Form
Child Client Intake Assessment

Adolescent Counseling Age 13-18

Child Client Information Form
Adolescent Intake Assessment

Adult Counseling Forms

General Client Information Form
Adult Intake Assessment

Court-Involved Forms

** All Court Involved Services will require the following forms to be completed as well as the forms listed under each service:

Required Forms

Notice of Privacy Practices
Court Involved Financial Information and Agreement
Authorization for Disclosure (for any individual I may need to speak with during the process i.e. Attorneys, therapists current and past, additional Court Involved providers current and past, spouses, teachers, etc.)

Therapeutic Intervention

Therapeutic Intervention Intake Agreement

Parenting Coordination

Parenting Coordination Informed Consent and Agreement
Parenting Conference Initial Document
Parent Information Regarding the Use of Parenting Coordinators

Supervised Visitation

Supervised Visitation Intake Form

Limited Family Assessment

Limited Assessment Informed Consent Overview
Explanation of Limited Assessments

Mediation and Collaborative Law Divorce Services

Mediation Agreement Contract
Divorce Planning Checklist
Parenting Plan Checklist
Collaborative Divorce Engagement Agreement - Family Relationship Specialist
Collaborative Divorce Engagement Agreement - Child Specialist