Forms

These are the forms used by CAPS to initiate treatment, obtain or release records, and bill insurance. Use the boxes below to find the forms you're looking for:

When a student is a minor, we need the following forms completed by a parent/guardian for CAPS treatment. Please also review our instructions for accessing services for students who are under 18.

Forms:

Consent to Treat a Minor

Consent to Treatment

Consent to Bill Insurance

Telehealth Consent Form

The following forms are used to give CAPS permission to request or release your records: 

CAPS Authorization for Release or Request of Information (Allows CAPS to RELEASE information to/REQUEST information from an outside provider)

In order to receive medication treatment for ADHD, the following packet will need to be completed and reviewed by the psychiatry team before an appointment can be made:

Consent Form for ADHD Evaluation

Find out more about our ADHD Services.