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GrowthBRINGS POSITIVE CHANGE

Helpful Forms

ALL NEW CLIENTS

Please print and complete the following form and bring it to your first therapy session.

CLIENT ASSESSMENT FORM





UCLA PROBLEM GAMBLING STUDY CLIENTS

Please print and fill out the following additional forms (required to enter the program) and bring them to your first theraphy session.


Declaration of Clients Rights and Responsibilities
Client handbook booklet
Consent to Telephone Monitoring and Follow Up Interview
Terms and Conditions of Service
Notice of Privacy Practices and Information Practices Act
Consent To Release Confidential Information
Request to Revoke Consent

Complaint Grievance

Patient Intake Form





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click here.





Helpful Forms

Click here to view and print forms for your appointment.

Click Here