Documents

From ResWiki

• Clinical Intake Info CMHC Needs

This document describes information we'll ask for during the clinical phone intake.

• Beyer's Treatment Consent Form

Dr. Beyer requires all parents with children in the special 15+ years of age subset to sign this form.

• Privacy Policy and Receipt

This privacy policy should be given to parents who should read it and sign at the bottom.

• Release of Information

This form requires a parent signature to allow for communication between ICCSD and CMHC staff.

Highlighted areas should be completed/signed.

• Confidential School Report for Mental Health Services

This document should be completed by the teacher who spends the most time with the student, by the counselor, or by another appropriate school staff member. Once completed, it gives CMHC clinical staff a better picture of the student's functioning at school.

• Informed Consent for Treatment

All parents must sign this informed consent document to allow their child to be treated at CMHC.

• Documentation of Attempts to Involve Parents

For the 15+ Special Circumstances Subset, this document must be completed and signed by the case manager, serving to record attempts to involve the parent/guardian in the child's treatment at CMHC.

• CMHC's Child Intake Process

This describes our general child intake process. Page 1 is for the Case Manager. Pages 2 and 3 can be given directly to parents/guardians. Please note, the intake process described is for those outside of the 15+ special population described in the Power Point presentation.

• Psychiatric Evaluation Summary for Schools

Dr. Beyer will complete and send this form to the school, where permitted by clients/families, to offer follow-up on her psychiatric evaluation.