“Providing Services for
Children and Families since 1965”

Client File Checklist

Main Menu

Print/View/Download any or all of the following:


Section 1: Client Information

Birth Family Contact Form

Consent for Release of Information

Personal Inventory

Section 2: Mental Health Assessment and Related Information

Application for Services - TX Permission


Discharge Summary

Quarterly Progress Review Addendum

Mental Health Assessment


Section 4: Progress Notes (Non-billable notes)

Internal Disruption Staffing

Notice of Removal

Client Weekly Progress Report

Client Monthly Progress Report

Respite Forms

Behavior Management Form


Section 6: Medical

HIV/AIDS/Health Information Form (ten years and older)

    Medical Appointment Log

    Medication Log

    Comprehensive Medical Examination

    Optical Exam Form

    Dental Exam Form

    Section 7: Diagnostic Tools

    Devereaux Early Childhood Assessment

    Section 8:

    Referral/Intake Information

    Youth Placement Forms

    Unattended Youth Form

    Change of Status Form

    Letters to Service Providers

    Two Week Assessment of Placement

    ICCA Form