Family Wellness Associates
  • Welcome to Our Place
    • Making Memories
  • Mental Health Services
    • Meet Our Mental Health Team
    • Couples Counseling
    • DBT
    • PCIT
    • EMDR
  • BHIS/HCBS Services
    • Behavioral Health Team
    • HCBS Services
  • Substance Abuse Treatment and Team
  • Employment Opportunities
  • Intake Forms
  • Additional Resources
  • TELEHEALTH
  • Contact

INTAKE FORMS

What to expect for your initial appointment


Arrive 30-45 minutes early
Please have a current ID
Any active insurance cards
Below are the intake paperwork


Picture

​Required (Individual) Intake Forms

Intake Packet
File Size: 162 kb
File Type: pdf
Download File

Release of Information (Fill-in Person or Organization)
File Size: 385 kb
File Type: pdf
Download File

PHQ-A Assessment Fill-in Form (Ages 11-17)
File Size: 317 kb
File Type: pdf
Download File

GAD-7 Assessment Fill-in Form (Ages 18+)
File Size: 32 kb
File Type: pdf
Download File

PHQ-9 Assessment Fill-in Form (Ages 18+)
File Size: 120 kb
File Type: pdf
Download File

Picture

Required (Couples) Intake Forms

Intake Packet
File Size: 162 kb
File Type: pdf
Download File

Picture

Required (Substance Abuse)
​Intake Forms

Intake Packet
File Size: 159 kb
File Type: pdf
Download File

AUDIT
File Size: 381 kb
File Type: pdf
Download File

MAST
File Size: 127 kb
File Type: pdf
Download File

DAST
File Size: 115 kb
File Type: pdf
Download File

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  • Welcome to Our Place
    • Making Memories
  • Mental Health Services
    • Meet Our Mental Health Team
    • Couples Counseling
    • DBT
    • PCIT
    • EMDR
  • BHIS/HCBS Services
    • Behavioral Health Team
    • HCBS Services
  • Substance Abuse Treatment and Team
  • Employment Opportunities
  • Intake Forms
  • Additional Resources
  • TELEHEALTH
  • Contact