Adult Paperwork

DemographicsHealth HistoryPHQ-9GAD-7Adverse Childhood Experiences (ACES) QuestionnairePCL-5

Child Paperwork

DemographicsHealth HistoryAdverse Childhood Experiences (ACES) QuestionnaireCATSVanderbilt Assessment Scale – ParentVanderbilt Assessment Scale – Teacher


Advance Directives Ohio FormConsumer Information PacketConsent for Treatment, Payment, & Healthcare OperationsInterested in ServicesUpload DocumentSliding Fee Application

AoD Paperwork


All persons setting a child up for therapy will be asked if they have the legal authorization to do so and the right to sign all necessary documents for that child’s treatment.  The guardian / parent must attend the intake appointment with the child and will be asked to bring any court papers giving them the right to authorize treatment.