Clinic Forms and Resources

Forms to Complete Prior to First Appointment

Privacy Practices
Privacy Practices for Couples
Child & Adolescent Developmental History
Adult Developmental History
Release of Information Form
Client Information Form
UCA – Informed Consent for Telephone and Teletherapy Services

FYI Forms

Information about Behavioral Health Services
Insurance & Billing Policies

Local Resources

Alcohol and Other Drug (AODA) Treatment Programs

(608) 266-1865

(888) 701-1251 (TTY)

Briarpatch

608-251-6211

Canopy Center

608-241-2221

Domestic Abuse & Intervention Services

608-251-4445

Family Advocates: Platteville

800-924-2624

Gay Straight Alliance for Safe Schools (GSAFE)

(608) 661-4141

Journey Mental Health Center

(608) 280-2720

NAMI Dane County, Inc.

608-249-7188

NAMI of Southwest Wisconsin

608-348-6136

Passages: Richland Center

800-236-HEAL (4325)

TransParent

(608) 663-8449

Unified Community Services of Iowa-Grant County

Dodgeville: 608-935-2776

Lancaster: 608-935-2776
Toll-free: 1-800-362-5717

United Way of Dane County

(608) 246-4357

2-1-1

University of Wisconsin Pediatric and Adolescent Transgender Health (PATH) Clinic

(608) 263-6420

Wisconsin Psychological Association

608-251-1450

National Resources

National Mental Health Information Center

1-877-726-4727

1-866-889-2647 (TDD)

National Institute on Mental Health

1-866-615-6464

1-866-415-8051 (TTY)

National Alliance on Mental Illness

1-800-950-NAMI (6264)

American Psychological Association

1-800-374-2721

1-202-336-6123 (TDD/TTY)

CHADD
National Eating Disorders Association
Obsessive Compulsive Foundation