New Client Forms Required for Minors Applicable for all clients 17 years old or younger Client Information Form Insurance Information Form Additional Insurance Information Fee Schedule for Services Credit Card Authorization Agreement 2012 Child Developmental History Child Supplementary Information Teacher Rating Scale Release of Information Release of Information for Referring Practice Signature on File Form Financial Policy Agreement Client Contract Notice of Policies and Practices

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New Client Forms Required for Adults

Applicable for all clients 18 years old or older

• Client Information Form
• Insurance Information Form
• Additional Insurance Information
• Fee Schedule for Services
• Credit Card Authorization Agreement 2012
• Adult Supplementary Information
• Release of Information
• Release of Information for Referring Practice
• Signature on File Form
• Financial Policy Agreement
• Client Contract
• Notice of Policies and Practices

Families in Transition/Collaborative Divorce

Applicable for all Families in Transition Clients

• Collaborative Divorce Personal History Form
• Collaborative Divorce Consent Form for Initial Consult
• Collaborative Divorce Release of Information

Other Forms:

• Credit Card Authorization Agreement 2012
• Release of Information
• Release of Information for Referring Practice
• Client Contract
• Notice of Policies and Practices