Intake Forms

Print and complete age appropriate form
Child Intake Form (Age 3-12)
Adolescent Intake Form (Age 13-18)
Adult Intake Form (Age 18+)

Intake Forms

Additional information
Financial Policy
Print remaining forms and complete. Completed forms needed at time of assessment
Authorization to Treat Minor
Authorization to Treat Minor
Disclosure and Informed Consent
Signature Form

Send me a message

Office on 2nd Floor in the Longbranch building in Downtown Nampa

16 12th Avenue South Suite 208

Nampa, Idaho 83651

Phone: 208-649-6048

Fax: 208-906-2343

Mon: 7am - 8 pm

Tues: 7am - 8 pm

Wed: 7am - 8 pm

Thurs: 7am - 8 pm

Fri: 7am - 5:00 pm

Saturday: Closed

​Sunday: Closed

Please send me a message if you are interested in services or have general questions.

© 2020 by Achieving Family Wellness