Complete ALL the information requested on the following forms and bring to the intake session. If you have scheduled an intake for both yourself and your child, you will need to complete the adult intake form as well as the Billing Agreement and Consent for Assessment. Complete a release if you want information released and/or obtained from the doctor, medication provider and/or other service providers.
Download these forms along with the forms above for Intake, complete ALL the information requested and bring to first session.
Parent’s Biography (for each adult caretaker in the home)
Parent Strengths and Needs Profile (for each adult caretaker in the home)
RADQ (for children 5 and over) or
Attachment Symptom Checklist for Children under 5 (if child is under 5 or was placed in the home before age 5)