Forms & Resources

We are making the following forms available to you so that you can download them from home if you wish to have them filled out prior to your appointment.

• Release of Information
• Release of Information - English
• Release of Information - Spanish
• Paperwork - Child Psychiatry
• Paperwork - Child Therapy
• Paperwork - Adult Psychiatry
• Paperwork - Adult Therapy
• Counseling Intake Form - English
• Psychiatry Intake Form - English
• Psychiatry Intake Form - Spanish
• Description Of Patient Rights
• Initial Intake Assessment Counseling
• Informed Consent for Telemedicine Services
• Service Agreement and Informed Consent Counseling
• Counseling Care Consent Form - English
• Counseling Care Consent Form - Spanish

Additional Resources

Rock County 24 Hour Crisis Intervention: 608.757.5025

American Association of Suicidology: 202.237.2280

Community Support Program: 608.757.5566

First Call for Help Information and Referral: 608.752.3100

HOPES Suicide Prevention Advocacy: 608.221.1044

Legislative Hotline for Wisconsin: 800.362.9472

NAMI Wisconsin: 800.236.2988

NAMI Help Line: 800.950.6264

National Suicide Hotline: 888.784.2433 (SUICIDE)

Treatment Advocacy Center: 703.294.6001