Telecounseling Forms
Thank you for allowing your child(ren) to receive our telecounseling services! We are so excited to connect with them and provide these services at no cost to your family. Please review the required telecounseling documentation below and complete based on which set applies to you and your child(ren).
Initial Telecounseling Forms (required for all new clients)
If you have already scheduled your child’s first appointment, please complete the following forms prior to your child’s first session. Please note that we cannot move forward with telecounseling services until these forms have been received.
- Consent to Telecounseling Services (signature)
- Prior to signing, please review the Consent for Telecounseling Services and the Parent/Guardian Informed Consent for Research
- Psychosocial Intake Form
- Behavioral and Emotional Screening System (BESS) Parent form
- Life Incidence of Traumatic Events (LITE) Parent form
- Parent Report of Post-traumatic Symptoms (PROPS) Parent form
**Note: If your child(ren) received services with us previously and it is a new academic year, then you are required to complete the Initial Telecounseling Forms again.
Follow Up Telecounseling Forms (required after every 5th session your child has completed)
If your child has already started counseling sessions and you have been notified by one of the Clinical Coordinators to complete follow up forms, please complete the following forms:
- Behavioral and Emotional Screening System (BESS) Parent form
- Parent Report of Post-traumatic Symptoms (PROPS) Parent form
- Psychosocial Follow Up Scale
Zoom Platform Instructions
For your child’s telecounseling sessions, we will be utilizing the Zoom for Healthcare platform. This is a secure platform that will ensure that no one else may enter your child’s session outside of your child, their counselor(s), and the counselors’ supervisor.
Prior to your child’s first telecounseling session, the counseling supervisor will send a Zoom link to the email that you have provided to us. In order to ensure your child(ren) may log in, please review the following instructions.
Zoom Instructions
If you’re unsure which set of forms you need to complete or have any additional questions, please reach out to Galaxina Wright or Kate Babb at 407-490-3886. We look forward to working with you!
