IMPORTANT INFORMATION

** Please bring Identification

** Please bring in all documents pertaining to your case: Court documents, Police reports, etc.

** The fee for the DVIT assessment is $150. Included in this fee is the cost for the Domestic Violence Inventory or DVI report as well as the WATCH background check.

·       Your able to make payment over the phone with Debit/Credit Cards, by mail with check payable to HPWC, or in person at 5007 NE St. John RD. Vancouver, WA 98661.

** Our Grievance Policy, Privacy Notification and Complaint Procedures, and Patient Rights provides you measures to help you if you have any concerns, problems or complaints here at HPWC.

**Releases of Information are in place for your privacy and security.

·       Please sign, initial, and/or date all highlighted areas.

A collateral contact is a source of information that is knowledgeable about your situation and serves to support or corroborate information provided by yourself. 
Communication with a collateral contact may be made in person, over the telephone, or by mail.

** The mental health screening form is an added tool for the clinician to better assist you.

** A collateral contact is a source of information that is knowledgeable about your situation and serves to support or corroborate information provided by yourself. Communication with a collateral contact may be made in person, over the telephone, or by mail.

** Please do not forget to bring this completed packet with you for your appointment.

** If you have any questions, or if there is anything else we can do to assist you in this matter please call our office at your earliest convenience (360.687.0693).