Consent & Intake Forms

Fill these out and bring them to your first visit. Please download the files from the links below.

Forms For Stephanie Rosebaugh

1. Stephanie Rosebaugh – Informed Consent Form
2. Stephanie Rosebaugh – Intake Form
3. Child & Adolescent Intake Form
4. Trauma Symptoms Checklist
5. Telemedicine Consent

Forms For Kyle Rosebaugh

1. Kyle Rosebaugh – Informed Consent Form
2. Kyle Rosebaugh – Intake Form
3. Child & Adolescent Intake Form
4. Telemedicine Consent

Forms for Lori Kidd

1. Lori Kidd – Informed Consent Form
2. Lori Kidd – Intake Form
3. Child & Adolescent Intake Form
4. Telemedicine Consent

Forms for Tracey Small

1. Tracey Small – Informed Consent Form
2. Tracey Small – Intake Form
3. Child & Adolescent Intake Form
4. Telemedicine Consent

Forms For Dr. Stacie Brown

1. Dr. Stacie Brown – Informed Consent Form
2. Dr. Stacie Brown – Intake Form
3. Child & Adolescent Intake Form
4. Telemedicine Consent

Forms For Devan Mckenzie

1. Devan Mckenzie – Informed Consent Form
2. Devan Mckenzie – Intake Form
3. Child & Adolescent Intake Form
4. Telemedicine Consent