Intake forms for clients 18+

Clients who are 18 or older need to sign our intake forms to continue services at Catalpa Health. The necessary documents are below.

A few things:

  • Please do not have your parents sign any of the forms. If they are obtaining legal guardianship for you after your 18th birthday, we have a different process. Those court documents can be submitted to us via fax to our privacy department at 920-882-0857.
  •  As a legal adult, we will not be able to communicate with your parents unless you sign a release of information for them. They will not be able to help schedule appointments, request medication refills, or anything else without your consent. At this time we do not have an electronic signature option for this. You can print one here, otherwise we can mail it to you or you can stop by our clinic.
  •  If you are still 17, please wait to sign the documents until your 18th birthday. They will be invalid if they are signed/dated prior to your birthday.
  • Please reach out to us if you have any questions about this process or need help with the forms. Our call center hours are Monday – Friday, 8:00-4:30 and out phone number is 920-750-7000.
1) Review these 3 forms:
2) Sign these 3 forms: