Client Forms — With Connection

Client Forms

Family and Child Therapy Intake Forms

Child and Family Forms:

Child Intake Packet

Child Demographic Form

Child Medical/Developmental Questionnaire

School Refusal Assessment Scale (Child)

Screen for Child Anxiety Related Disorders (8-18 yrs)

Generalized Anxiety Disorder (GAD) (11-adult)

Beck's Depression Inventory (13 and older)

Adult Forms:

Adult Intake Packet

Adult Demographic Form

School Refusal Assessment Scale (Parent)

Cross-Cutting Symptoms Measure (Adult)

PTSD Checklist for DSM-5 (PCL-5) - Adult

Beck's Depression Inventory (13 and older)

Generalized anxiety disorder (GAD) (11-adult)

Parental Stress SCale (PSS)

Patient Health Questionnaire-9 (PHQ9) - Adult

All Client Forms:

Release of Information/Protected Health Information

Grievances and appeals policy