​Below you will find our Statement of Understanding, Your Rights and Responsibilities, and Telehealth Consent form for you to sign allowing us to provide services to you as a client/patient.  In addition, there are some Release of Information forms  so we can gather collateral information prior to your appointment.   
Please fill it out and sign at the bottom and SUBMIT. 
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If you have any questions or problems accessing documents, please call 641-752-1585 or email us at info@centerassoc.com.

New & Current 
​Client Forms
(Adults)

Statement of Understanding

Physician Release

Emergency Contact Release

Mental Health Provider or Facility Release

General Release Form (Not Required)

New & Current
​Client Forms
​(Children & Adolescent)

Statement of Understanding

Physician Release

Emergency Contact Release

Mental Health Provider or Facility Release

Central Rivers AEA Release

School District Release

General Release Form (Not Required)

New School Based Services Forms 

Please fill out ONLY if directed to do so by a school counselor or Center Associates employee. 

Registration Form

School-Based Services Consent Form

Statement of Understanding

Emergency Contact Release

Central Rivers AEA Release

Physician Release

School District Release

Vanderbilt Assessment (For Parent/Guardian)

Vanderbilt Assessment (For Teachers ONLY)

Four Oaks Release (ONLY for Four Oaks Students)

General Release Form (Not Required)