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Achieving Family Wellness
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
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