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Documents and Forms

These pdf documents are available for you to download and fill in prior to your visit.

New Client Forms
Adult Intake Questionnaire
Child Intake Questionnaire
Client Information & Consent 2011
HIPAA Acknowledgement
HIPAA Policies
Client's Rights Brochure
Children's Rights Brochure

Additional Forms
Release of Information
Medicare Signature
Credit Card Authorization
Therapist Overviews

Family Resources Associates, Inc.- A Full Service Mental Health Clinic
Watertown location: 920.261.4100 | Lake Mills location: 920.648.3896 | Fax: 920.261.8801