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

Credit Card on File Policy

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 Family COVID Letter

ABA Clinic Location Acknowledgement

 

Clinician Disclosures (for associate therapists)

Clinician Disclosure – Karlee Smith, LMHCA

Clinician Disclosure – Emily Taylor, LMHCA

Clinician Disclosure – James Calvet, LICSW, LSWAIC

Clinician Disclosure – Paulina Gralow, 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

 

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