Child / Adolescent Group Intake Forms

Live flowerPlease print and complete all forms when directed. Please do not complete or submit these forms unless you have been accepted as a client and are starting group services.

Please return the completed forms and return as instructed by Office Staff.

After these forms are received we will verify the insurance and contact you to schedule a 30 minute orientation and group assessment with the group therapist.

  1. Child-Adolescent Intake
  2. 2019 InformedConsent-Group TherapyAgmt-Child
  3. Group Appropriateness - Parent (for minors younger than 14  years old)
  4. Group Appropriateness 14 (1) (for minors 14+years old. Child should complete their own form)
  6. Telehealth Consent
  7. Covid 19 Precautions Agreement