Please be aware! Due to confidentiality laws, if you are the parent, relative, or caregiver of a client who is eighteen (18) or older, the client will need to call to schedule/reschedule appointments, and will need to be the person to fill out the below forms. We cannot verify any appointment information (or even confirm an appointment) without a documented release form from the client.
New Client Forms for Adults
- HIPAA Privacy Notice
- Informed Consent for Returning to In-Person Services
- Informed Consent for Telepsychology
- Outpatient Services Contract
- Adult Intake
- Release of Information
New Client Forms for Children
- HIPAA Privacy Notice
- Informed Consent for Returning to In-Person Services
- Informed Consent for Telepsychology
- Outpatient Services Contract
- Child Intake
- Release of Information
COVID-19 Forms
- Safety Protocol COVID-19
- Health-Screening Questionnaire
- Informed Consent for Returning to In-Person Services
Amy Carroll-Collins Clients Only
- HIPAA Privacy Notice
- Informed Consent for Returning to In-Person Services
- Informed Consent for Telepsychology
- Outpatient Services Contract
- Adult Intake
Questionnaires
- Teacher Questionnaire
- Parent Questionnaire
- Parent Questionnaire (6 to 18 Year Old)
- Child Symptom Checklist
- Screen for Child Anxiety Related Disorders (SCARED) – Child Version
- Screen for Child Anxiety Related Disorders (SCARED) – Parent Version
- CES-D Child Version
- CES-D Parent Version
PDFs
- HIPAA Privacy Notice
- Safety Protocol COVID-19
- Informed Consent for Returning to In-Person Services
- Informed Consent for Telepsychology
- Outpatient Services Contract
