For Clients & Families: Forms

General Catalpa Documents:

Release of Information/ Authorization for the Disclosure of Health Information  

(ROI)  To request copies of medical records or to permit another person to participate in your child’s care, please complete and return. 

Mental Health Treatment Plan  

Electronically sign this document when instructed to by your provider.

Informed Consent for Treatment  

Electronically sign this document when instructed to.

Behavioral Health Form For Psychological/Neuropsychological Testing

Complete and return when instructed to for psychological testing.

Intake forms for new clients

Electronically sign these documents when starting services at Catalpa Health.

18 Year + Paperwork

Current clients who turn 18 need to electronically sign these documents. New clients who are 18 or older will need to electronically sign these, as well.

Update Insurance

Complete this electronic form when there has been an insurance change for a client.

Notice of HIPAA Privacy Policy

This notice describes how medical information about you/your child may be used and disclosed and how you can get access to this information.

Catalpa Client Policies and Procedures