All forms (other than registration forms) must be completed and returned to the office in person or by mail, they cannot be submitted online. Mail or bring forms to: The Children's Program, 7707 SW Capitol Hwy, Portland, OR, 97219.
Please complete the forms using one of the two following methods:
- Print out the forms and then complete them.
- Complete forms on your computer via PDF or MS Word. Forms must then be printed out and returned to the office. If you cannot print out the forms, please call the office and we will mail the forms to you.
If you have any questions about completing these forms, please call our office (503) 452-8002.
2. Consent for Payment and Healthcare Operations: PDF Word
3. Child Development Questionaire: PDF Word
4. Adult Questionaire: PDF Word
5. Release to Disclose Confidential Information: PDF Word
6. Consent to Treatment: PDF Word
7. Healthcare Coordination Form: PDF Word
8. Acknowledgement and Consent Forms: PDF Word
10. Financial Policy for Groups
11. ADD/ADHD Beginner's Group: PDF, Winter 2012 Calendar: PDF, Spring 2012 Calendar: PDF
12. Paying Attention to Attention: PDF, Winter 2012 Calendar: PDF, Spring 2012 Calendar: PDF
Please note, some of these forms require Adobe Acrobat to display and print |
