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.
If you have any questions or problems accessing documents, please call 641-752-1585 or email us at info@centerassoc.com.
Please fill it out and sign at the bottom and SUBMIT.
If you have any questions or problems accessing documents, please call 641-752-1585 or email us at info@centerassoc.com.
New & Current
|
New & Current
|
MCSD School Based Services FormsPlease complete only if your child has been referred for Marshalltown Community School District school-based therapy services.
|
Formularios de servicios basados en la escuela de MCSD (SBYS forms in Spanish)Complete solo si su hijo ha sido referido para los servicios de terapia basados en la escuela del Distrito Escolar de la Comunidad de Marshalltown.
|