To register as a client at Center Associates, please call 641-752-1585 before filling out any forms below!

​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.

Center Associates Brochure (English)

Notice of Privacy Practices

Center Associates Brochure (Spanish)

New & Current 
​Client Forms
(Adults)

Statement of Understanding

Physician Release

Emergency Contact Release

Emergency Plan & Release

Mental Health Provider or Facility Release

Notice of Privacy Practices Acknowledgement

General Release Form (Not Required)

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

Statement of Understanding

Physician Release

Emergency Contact Release

Emergency Plan & Release

Mental Health Provider or Facility Release

Central Rivers AEA Release

School District Release

Notice of Privacy Practices Acknowledgement

General Release Form (Not Required)

MCSD School Based Services Forms
(English & Spanish forms)

Please complete only if your child has been referred for Marshalltown Community School District school-based therapy services for the 2022-2023 school year. 

2022-2023 SBYS Registration & Releases

Four Oaks Release (ONLY for Four Oaks Students)

General Release Form (Not Required)

Vanderbilt Assessment (For Parent/Guardian)

Vanderbilt Assessment (For Teachers ONLY)