360-305-3275  360-734-5503

Forms

If your provider at Sendan Center has asked you to complete any of the forms below, please click the link for the appropriate form to fill and submit online.

General Forms:

Release of Information

Telehealth Consent

Appointment Reminder Consent

Updated Financial Agreement

Consent for Treatment

Stimulant Medication Guidelines

Patient Portal Request Form

 

Screeners and Assessments:

Vanderbilt Assessment Scale – PARENT Informant

Vanderbilt Assessment Scale – TEACHER Informant

 

ABA Forms:

Sendan ABA Disclosure

ABA Family Update Form

ABA – Request for Non-Secure Communication

ABA Parent Manual

ABA Clinic Location Acknowledgment

If you have been specifically asked to complete a form to join one of our established client social groups, please click the link below to fill and submit the form online. Please note: Sendan’s social groups are currently only available to established clients who have been referred internally, please do not fill out the form below if you have not already spoken to our team about joining a social group.

Established Clients Only – Social Group Agreement (printable version here)

 

Clinician Disclosures (for associate therapists)

Clinician Disclosure – Ray Almeyda, LMHCA

Clinician Disclosure – Paulina Gralow, LMHCA

Clinician Disclosure – Brock Knowles, LMHCA

 
Handouts

Handout – How to Reduce the Odds Your Child Will Harm Themselves

Handout – Healthy Sleep Habits for Children and Teens

Handout – Parenting a Child Who Has Intense Emotions

Handout – Anxiety in Children and Adolescents

Handout – Resonance Breathing

 

Have a different document or form to submit to your provider?

You can upload documents to our secure, third-party document portal through the link below:

Send a Document

(Please note: this portal is for uploading documents only, and is not a way to communicate directly with your provider. For any urgent messages, please contact the front office at 360-305-3275) 

If you are looking for your provider’s telehealth address, click here