Forms for Providers

First Session In-Community Enrollment Documents

Service Encounter Form

Patient Discharge Summary Form

Child and Family Team Meeting Form

Emergency Contact Form and Crisis Form

HIPAA Medical Release Form

Tele Health Patient Consent Form

Patient Social Media Policy

Treatment Plan

Crisis Safety Plan

Tele-Health Service Encounter Form

Counselor Licensure Disclosure Form

Timesheet

Incident Report

Malpractice Insurance Form