Forms

Important information about CPSD forms:

  • All forms require Adobe Reader - click here to download. 
  • Forms do not link to the CPSD or transmit information electronically to the CPSD. 
  • Please do not return completed forms to the CPSD via e-mail. We encourage you to protect your privacy.

Forms for New Clients

You are encouraged to print and complete these forms to bring with you to your first appointment.  We cannot accept these with your application.

Acknowledgement of Receipt of Privacy Practices‌  Acknowledgement of Receipt of Privacy Practices

  • Use this link to download a copy of the CPSD's Privacy Practices: Privacy Practices

Informed Consent

E-mail Consent

Emergency Contact Information

Other Client Forms

Consent for Release of Information

Request for Records

Authorization for Use of Credit Card