Client Forms
Have you completed a request for services with our Access Department? If so, please complete your pre-assessment paperwork below. If not, please contact our Access Department at 425-349-8200 / 844-822-7609 or complete our Online Referral Form to start your referral process.
Instructions on how to sign & submit the below Pre-Assessment forms electronically
- Signing on your computer:
- Signing on your mobile device:
Forms should be completed using Adobe Acrobat Reader DC on your computer or mobile device. Adobe Acrobat Reader DC is free to download here.
Pre-Assessment Forms
After speaking with the Access Team, if you will be participating in a Telehealth appointment, fill out the Pre-Assessment Forms. You can access each form below by clicking on the name of the form in orange:
- Consent for Treatment
- The following individuals may sign a Consent for Treatment:
- Adults age 18 and older, unless declared incapacitated by a court of law (i.e. have a legally appointed guardian).
- Minors age 13-17
- Parents of a minor child (age 17 or younger) – adolescents should sign their own pre-assessment paperwork forms
- Legal guardians
- Kinship Caregivers – family members of a child under the age of 13 who are providing care for the child in the absence of a parent or legal guardian. Parent/guardian is not available.
- If the client is unable to sign for themselves (i.e. under 13, or an adult with a legal guardian) someone who can sign consent must attend the assessment with the client, or must sign the Consent for Treatment in advance).
- How to complete the Consent for Treatment:
- Check all applicable boxes on pages 1
- For packet material, only need to check the Financial Agreement box
- Sign and date on page 4
- Enter your Name & DOB on each page
- Only Kinship Caregivers must complete page 5
- Check all applicable boxes on pages 1
- The following individuals may sign a Consent for Treatment:
- Financial Agreement
- How to complete the Financial Agreement:
- Check all applicable insurance boxes on page 1
- Must include your ProviderOne ID # in the Medicaid section (example: 123456789WA)
- Sign and date on page 2
- Enter your Name & DOB on each page
- Check all applicable insurance boxes on page 1
- How to complete the Financial Agreement:
- ROI (Release of Information) – see note below
- If you are not intending to release, exchange, or disclose your medical records to another individual, then do not complete the ROI at this time.
- Who can sign an ROI? If the client is 13 or above, they must sign the ROI; if the client is 12 or younger, a parent/guardian must sign the ROI.
- In order to best assist your treatment, it is strongly encouraged to complete the following ROIs:
- PCP
- If a minor client is age 13 or above, we strongly encourage an ROI for the parent or guardian.
- Other typical ROIs that we request from new clients include requests from School Counselors, Social Workers, other Medical Providers including recent hospitalizations, etc.
- Instructions for completing an ROI:
If this is a standalone request for information unrelated to submitting pre-assessment forms, please go to our Medical Records page.
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Client Forms Submission

Client Forms Submission
Please submit your completed forms here (Consent for Treatment, Consent for Telehealth, Financial Agreement, ROI). Please submit all the signed and dated forms together.