- You Are Here:
- Home
- Town Departments
- Youth & Family Services
- Clinical Services
- Clinical Forms
Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
During your first session, your clinician will review all necessary paperwork for treatment. The links to our clinical forms maybe found below in case you would like to review them in advance. You may also print and complete these forms in advance and bring them to your first session.
Notice of Privacy Practices Opens a New Window.
HIPPA Disclosure Opens a New Window.
Consent for Treatment - Outpatient Clinic Opens a New Window.
Consent for Treatment - School Based Counseling Opens a New Window.
Outpatient Counseling Fee Agreement Opens a New Window.
Authorization to Bill Insurance Opens a New Window.
Confidential Parent Questionnaire Opens a New Window.
Confidential Teen Questionnaire Opens a New Window.
Release of Information Opens a New Window.
Medication Flow Sheet Opens a New Window.
Audiotaping and Videotaping Consent Form Opens a New Window.
Informed Consent for In-Person Services during COVID-19 Public Health Crisis Opens a New Window.