Consent for Services
Catherine's Health Center School Behavioral Health Program services may include behavioral and mental health assessment, treatment, individual therapy, and group therapy
I understand that my child may be put on a waitlist depending on the number of openings in the clinician's caseload, but that I can contact them at anytime through the Crossroad's office.
As a parent/guardian, I agree to play an active role in the process as requested by the clinician I understand it is not necessary to renew my consent yearly
I understand I may withdraw my consent for services at any time upon written notice
Minor children without a signed consent form on file will not be seen. Exceptions to this include: students who are legally emancipated; legally married; under court-order; in the presence of a law officer when the parent cannot be promptly located; and *minor confidential services
I understand that no student will be turned away due to lack of insurance and all students will be seen regardless of their ability to pay. When available, insurance will be billed.
I understand that after therapy sessions begin, I have the right to withdraw my consent for treatment at any time and for any reason, however, I agree to make every effort to discuss any concerns about my child's progress and/or other reasons for termination with my child's provider prior to terminating.