Client Forms

Forms – All Non-Court Involved Clients & Families

• Teletherapy Informed Consent Agreement  (Please complete and return to therapist if participating in Teletherapy during the COVID health crisis)
• Social Media Consent
• New Client General Information Form
• Notice of Privacy Practices
• Counseling Informed Consent
• Insurance Treatment Agreement & Insurance Release
• Counseling Rights, Guidelines, & Responsibilities
• Child Checklist of Concerns
• Agreement To Pay For Services
• Agreement for parents
• Adolescent Privacy Policy
• Release of Information

Forms – All Court-Involved Therapy Services, including Reintegration Therapy & Therapeutic Supervised Visitation.  (Families working directly with KIDS Services will not need to complete the Credit Card Authorization Form below) .

• Reintegration Therapy/Therapeutic Supervised Visitation New Client/Family  Intake Form
• Release of Information
• Credit Card Authorization for Court-Involved Therapy
• COURT-INVOLVED THERAPY AGREEMENT

All forms need to be completed and returned to therapist on date of first scheduled appointment or prior to scheduling.  Forms can be scanned and emailed to [email protected] or faxed to 208-908-0058

Please note – Neither email or fax are guaranteed to be secure and confidential.  Please read the documents above addressing email and other forms of web based communication prior to sending completed forms containing sensitive information.

If you have questions regarding which forms you will need to complete based on your personal therapy needs and circumstances, don’t hesitate to contact Nekane Arrieta-Resnick, LCPC.