FOrms

Incident Report 

Consent for Release of Information 

Consent for Audio and/or Video Recording of Counseling Session- Please ask client to sign consent for each counseling session that is recorded.

Change of Client Information Form. - Form for clients to change information such as insurance, credit card on file, phone number, address, ect.

Financial Agreement

Informed Consent

Informed Consent for Non-Client Participant- Form for a non-client adult to complete if joining an established adult client for counseling (as part of checking in, or to gain additional information about the client) . If the non-client adult is or starts to participate in family counseling, please ask them to fill out a new client info form so that they can be given additional documentation and scheduled for an intake session.

Treatment Advocate Consent Form - Form for client to complete to identify a treatment advocate.

Treatment Advocate Acknowledgement Form - Form for treatment advocate to complete

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GAD-7- General Anxiety Disorder 7. Assess intensity of anxiety over the past 14 days. 

PHQ-9- Patient Health Questionnaire 9. Assess intensity of depressive symptoms over the past 14 days. 

PCL-C Six Item- Post Traumatic Stress Disorder Checklist- Civilian Version. Assesses PTSD symptoms over the past 30 days.

PCL- 5 - Post Traumatic Stress Disorder Checklist. Assesses PTSD Symptoms over the past 30 days. Extended 20 item version of the PCL-C Six Item.