Forms

Forms

Registration Forms:

Adult Questionnaire with Optional Couples Addendum*

Child/Adolescent Questionnaire*

Domestic Violence Group Registration*

*If you would like to print any of the forms and fill out by hand, click on the above link for the correct form. Then enter your name and email and then click continue. You will then see, "Fill this out by hand," which is located in the upper right corner of the web form. Click on this link and then print.

Consents to Participate in Treatment:

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HIPAA Privacy Practices:

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Release of Medical Records:

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Release of Confidential Information:

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CCP Referrals:


BIP Referral (CCP Use Only)

SA Referrals (CCP Use Only)