Enrollment and Renewal Forms

Thank you for choosing Transformations for your services.  Please take a few minutes to tell your provider about yourself and to sign the legal documents that give permission to start services.   Some of thenfollowing forms require the signature of the client or legal guardian. You will be asked to complete these forms prior to care and annually to continue care.

Permission for Treatment

Transformations believes in a holistic approach to client care that recognizes the relationship between mental health and physical health. Collaboration of care with a client’s primary care physician and medical professionals will enable better outcomes. If you are taking a prescribed medication or are considering medication, we highly recommend you authorization to share your diagnosis and treatment recommendations with your prescribing healthcare providers. This form maybe used for releases to various providers such as your Primary Care Physician and a Psychiatrist. 

Authorization to Share Information

Identify an emergency medical contact person.  This person will be contacted in the event of an emergency. Clients receiving Telehealth services must provide an emergency contact person per state regulations.

Authorization to Share Information-select emergency medical contact

You may chose to include a family member in your treatment process or want us to share records with an attorney or social worker or fostercare program or a psychiatric hospital.  Children ages 12 and older are asked to sign permission to share information with their parents.

Authorization to Share Information

 

Tell us about yourself and the reasons you are seeking services.  Have prescription information available prior to starting.  Do this  form now at the start of services and again every six months.

Client Information

once you and your provider have met and agreed upon a plan for treatment, come back and sign this form.  Parents, children and teens may sign separate forms to indicate participation and agreement with the plan of care.

Approval of the Treatment Plan

 

 

Thank you for your time in completing these forms and allowing Transformations to serve you.