Permission forms are provided to help make the intake process quicker as well as to allow parents the ability to read the forms prior to intake in case any questions arise.  Please be aware that there may be additional forms for you to read and sign upon intake.  All forms apply to admissions in Menomonie and in River Falls.

Parent Permission Forms

Forms for all Intakes (.doc file / .pdf file):

Placement Agreement and Medical Authorization / Placement Agreement and Medical Authorization

Lost or Stolen Items Agreement / Lost or Stolen Items Agreement

Emergency Medical Treatment Consent form / Emergency Medical Treatment Consent form

Activity Authorization Form / Activity Authorization Form

psychotropic med consent form / psychotropic med consent form

Authorization Release of information / Authorization Release of information

Drug Screen consent / Drug Screen consent

Photo-Video Release / Photo-Video Release

Situational forms:

Voluntary Placement Agreement / Voluntary Placement Agreement

 

For more information, please contact one of our group home program coordinators, Jeremy Hernandez in Menomonie or Kelli Kamholz in River Falls.