Intake Forms

Links to forms: 

Select one of the following to complete: 

Individual Intake - for those seeking individual therapy who are 15 and older

Couples Intake - for those seeking couples therapy 

Family Intake - for those who are 15 and older seeking family therapy

Child Intake - to be completed by both parents of a child younger than 15


Everyone 15 and older and both parents of children younger than 15 must compete the following forms: 

Disclosure and Informed Consent
HIPAA Agreement
Release Of Information for DAC
Credit Card Authorization

After you have met with your therapist several times, please let us know how we are doing by completing our Client Survey, we want your feedback! 

Additional Forms: (Please only complete these forms if you have been asked to do so by your therapist).

Health First Colorado Member Handbook
Release of Information- Friend, Family, or Provider
Collateral Disclosure Form
Video Recording Consent Form

Therapist Forms: (must be a therapist at DAC to complete these forms)
Safety Plan                                       Risk Assessment
Treatment Plan                                 Progress Note​              ​
Supervision Summary (E)               Treatment Summary
Supervision Summary (I)