New Client Forms


New Client Forms – English

After you speak to a therapist or case manager, you can complete the following three forms via the internet. Your completed forms will be sent to the therapist or case manager you choose on the forms.

CCD Registration – English
Client Information and Consent – English
Notice of Privacy Practices – English

If you are going to be seen virtually, you also need to complete this form:
CCD Telehealth Consent – English

New Client Forms – Spanish

Luego de que usted hable con el terapista o manejador de casos, usted debe completar los siguientes tres formularios por internet. Los formularios completados serán enviados a el/la terapista o anejador(a) de casos que haya selecionado en el formulario.

CCD Registro de Cliente – Spanish
Informacion del Cliente y Consentimiento – Spanish
Aviso de Practicas de Privacidad – Spanish

Si usted va a ser visto de manera virtual, también necesitará ompletar este formulario:

Declaración de Entendimiento de Asesoramiento por Telesalud – Spanish

New Family Tree Client Forms – English

If you are a client in the Family Tree program, you will be completing these additional documents:

Client Enrollment Form – English
Family Tree Authorization Form – English
Caregiver Survey – English

New Family Tree Client Forms – Spanish

under construction

Questions? Contact your therapist

Family Tree Jot Forms

If you have had difficulty signing docs, you may be sent here for signatures:

Family Tree Consent and Authorizations Form
Consentimiento Y Autorizaciones Del Programa Arbol Familiar