Forms for Medicaid Clients
This section includes forms for all Medicaid funded services.
Forms for non-Medicaid Clients
This section includes forms for all individuals that are seeking counseling services who are not using Medicaid insurance.
- Client Information Form - adult.pdf (42K)
- Client Information Form - child.pdf (42K)
- HIPAA Privacy Notice.pdf (42K)
- Information and Consent for Treatment Form.pdf (57K)
- Release of Information.pdf (27K)
Referral form to request mental health services.