Information for Clients

This form provides an overview of all the pertinent information for client's of Collaborative Change as well as crisis phone numbers.

Joint Notice of Privacy Practices

This is the comprehensive release form that all client's must sign at intake. This provides information regarding grievance policy, fees, crisis lines, how to access files and fees.

Consent to Release Information

If any client want's to involve a familly member, referral source or community agency in service or to coordinate care a release of information must be obtained by the therapist.

Child Consent to Treat

All parents/guardian must sign this consent to treat at intake in order for us to be able to provide therapy services to minors.

Child Intake Form

Child Intake Form must be completed prior to or at intake assessment with your therapist.

Child Intake Checklist

This is a brief checklist to give family history that must be completed at or before intake assessment with your therapist

Adult Consent To Treat

Adult Client's must sign this form at intake consenting to treatment.

Adult Intake Form

Adult Intake Form must be completed prior to or at intake assessment with your therapist.

Adult Intake Checklist

​This is a brief checklist to give family history that must be completed at or before intake assessment with your therapist.

Comprehensive Wraparound Release

For all of our client's participating in Wraparound Services we must obtain a comprehensive release to protect confidentiality. 

Adult Intake Checkslit

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Adult Intake Form

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