CENTER ASSOCIATES
  • Home
  • Make a Payment
  • Paperwork (New & Current Clients)
  • Clinical Team
    • Abby Shannon, MS, LMHC, NCC
    • Alice Shannon, Therapy Dog
    • Angela Krier, MSW, LISW
    • Christina Gonzalez, ARNP
    • Dawna Heil, MS, LMHC
    • Douglas Steenblock, MD
    • Duane Eberly, BSW
    • Erin Hatcher, ARNP
    • James Khile, MHR, LMFT
    • Kimberly Hagen, MSW, LISW
    • Kristin Pikna, MA, TLMHC, NCC
    • Lisa Rock, ARNP
    • Megan Eichmeier, ARNP
    • Michael Bergman, MS
    • Millie Shannon, Therapy Dog
    • Morgan Oliver, MSW, LMSW
    • Nakomis Maher, MSW, LISW
    • Nicolas Calzada, MSW, LISW
    • Paul Daniel, PhD, LMHC
    • Ron Eberline, MS
    • Tyler Determann, MSW, LMSW
  • Patient Portal
  • TeleHealth
  • Our Services
  • Integrated Health Services
  • Jail Diversion
  • BHIS & In Home Family Therapy
  • Our History
  • Attendance & Scheduling Policies
  • Privacy Practices
  • Education & Training Center
  • Employment
  • Contact Us
  • COVID-19 Update
  • Additional Emergency Mental Health Resources
  • Client Feedback
  • Home
  • Make a Payment
  • Paperwork (New & Current Clients)
  • Clinical Team
    • Abby Shannon, MS, LMHC, NCC
    • Alice Shannon, Therapy Dog
    • Angela Krier, MSW, LISW
    • Christina Gonzalez, ARNP
    • Dawna Heil, MS, LMHC
    • Douglas Steenblock, MD
    • Duane Eberly, BSW
    • Erin Hatcher, ARNP
    • James Khile, MHR, LMFT
    • Kimberly Hagen, MSW, LISW
    • Kristin Pikna, MA, TLMHC, NCC
    • Lisa Rock, ARNP
    • Megan Eichmeier, ARNP
    • Michael Bergman, MS
    • Millie Shannon, Therapy Dog
    • Morgan Oliver, MSW, LMSW
    • Nakomis Maher, MSW, LISW
    • Nicolas Calzada, MSW, LISW
    • Paul Daniel, PhD, LMHC
    • Ron Eberline, MS
    • Tyler Determann, MSW, LMSW
  • Patient Portal
  • TeleHealth
  • Our Services
  • Integrated Health Services
  • Jail Diversion
  • BHIS & In Home Family Therapy
  • Our History
  • Attendance & Scheduling Policies
  • Privacy Practices
  • Education & Training Center
  • Employment
  • Contact Us
  • COVID-19 Update
  • Additional Emergency Mental Health Resources
  • Client Feedback

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. 

​
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 

Please complete only if your child has been referred for Marshalltown Community School District school-based therapy services.  
Registration Form
MCSD School-Based Services Consent Form (2022-2023)
Statement of Understanding
Emergency Contact Release
Central Rivers AEA Release
Physician Release
School District Release MCSD
Notice of Privacy Practice Acknowledgement
Four Oaks Release (ONLY for Four Oaks Students)
General Release Form (Not Required)
Vanderbilt Assessment (For Parent/Guardian)
Vanderbilt Assessment (For Teachers ONLY)

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.
Formulario de inscripción
Formulario de consentimiento de servicios basados ​​en la escuela de MCSD (2022-2023)
Declaración de Entendimiento
Liberación de contacto de emergencia
Autorización Central Rivers AEA
Divulgación de Información al Médico
Autorización Escolar MCSD

Marshalltown Office
Center Associates

9 N 4th Ave 
Marshalltown, IA 50158
641-752-1585 (telephone)
​641-752-9665 (fax)

Toledo Office
Center Associates
1309 S Broadway
Toledo, IA 52342
641-484-5234 (telephone)
​641-484-5632 (Fax)