Instructions to complete fillable pdf forms:
- Find the type of service you are participating in or the specific form you need.
- Download to your computer or android device and open with Adobe (Apple devices may be different).
- Completely fill out each form (please complete a set of forms for each person scheduled).
- When completed "save as" to your device (the forms will be received blank if you do not to this step).
- When all required forms are completed, attach and e-mail them to our office. Send the forms to [email protected]
Other ways to complete the forms:
Everywhere it requires a signature, just type your name.
*If you are a new client, scheduled a new service, or new class participant, you must fill out and send the required forms before your scheduled appointment*
- Find the type of service you are participating in or the specific form you need.
- Download to your computer or android device and open with Adobe (Apple devices may be different).
- Completely fill out each form (please complete a set of forms for each person scheduled).
- When completed "save as" to your device (the forms will be received blank if you do not to this step).
- When all required forms are completed, attach and e-mail them to our office. Send the forms to [email protected]
Other ways to complete the forms:
- If filling out on a phone or tablet you can take a screen shot of the filled out forms, sending back the picture through e-mail.
- Print out, fill out and take a picture of each and e-mail the photos.
- Call the office and arrange to fill out in person (909) 985-0513.
Everywhere it requires a signature, just type your name.
*If you are a new client, scheduled a new service, or new class participant, you must fill out and send the required forms before your scheduled appointment*
| notice_of_privacy_practices_-_updated.pdf |
Cash or Insurance - New client forms packet
Please fill out all and submit to [email protected]
| cash-insurance-required_forms.pdf |
CFS - New client forms packet
Please fill out and to [email protected]
| cfs_-required_forms.pdf |
Parent Education Class - New client forms
Please fill out and to [email protected]
| parent_education_-cfs_-_required_forms.pdf |
Domestic Violence for Survivors class - New client forms
Please fill out and to [email protected]
| dv_class_-cfs_-required_forms.pdf |
Consent for Release of Information Form
| consent_for_release_of_information_or_records_2019_-_english_-fillable.pdf |
Acknowledgement of Rates for Legal Purposes
| 6-legal_purposes_-fillable.pdf |