Forms

Disclosure Forms

Disclosure Forms are filled out for ALL CLIENTS regardless of age. Clients age 12-17 need to sign along with their parents. 

Child Intake Form

The Child Intake Form is to be filled out by the parents of all clients age 4-12.

Adolescent Intake Form for Parents

This Intake Form is to be filled out by the parents of all clients age 12-17.

Adolescent Intake Form for Client

This Intake Form is to be filled out by all clients age 12-17.

Consent To Contact

Occasionally it is necessary for Amy to connect with other family members, doctors, teachers, or counselors in the clients life. This is only done with written permission by having this form filled out and signed.