For new clients

Upon completing New Client Paperwork, please contact the Project Connection intake team at 385-441-4900 to confirm receipt of documents and verify insurance.

Intake Forms

CLIENT INTAKE FORM

CONSENT FOR TREATMENT

GRIEVANCE FORM

ADVERSE CHILDHOOD EXPERIENCE (ACE) QUESTIONNAIRE

HIPAA SIGNATURE DOCUMENT

HIPPA NOTICE OF PRIVACY PRACTICES

CONSENT TO TREATMENT BY NON-CREDENTIALED EMPLOYEE

PROJECT CONNECTION'S RELEASE OF INFORMATION

MEDICAID ONLY FORMS

MEMBER ACKNOWLEDGEMENT FORM

TRANSPORTATION AUTHORIZATION