Welcome New and Existing Clients to our “Forms” page. Here you will find links to our various forms, as you begin or are continuing on your journey of self-awareness, with Wentworth and Associates.
NOTE:
Please allow enough time (approximately 30 minutes) to fill in the forms. Once you begin filling in the forms, you must complete each one, in its entirety, as there is not an option that allows you to “Save” and return at a later time.
Instructions:
Once you have clicked on the appropriate link below (Adult Packet or Child/Adolescence Packet), you will be directed to a secure and encrypted site. Please fill in an answer for each question on each form.
Please fill out the New Client Registration Form (if you have not already given this information via phone to our Intake Specialist or to a Therapist, previously.)
If you need any assistance, please contact your individually assigned therapist, fill out the Contact form, or leave a message at 586-997-3153.
Thank you,
The Wentworth and Associates Staff
Necessary forms for Adults (usually completed after you schedule with a therapist and before your first session):
- Adult Intake Packet
Online Form or Printable PDF Adult Intake Packet - Adult OQ30
Online Form or Printable Version
Necessary forms for Children (usually completed after you schedule with a therapist and before your first session):
- Child / Adolescent Intake Packet
Online Form or Printable Version - Youth OQ30
Online Form or Printable Version
Necessary forms for Families (usually completed after you schedule with a therapist and before your first session):
- Family Member Forms
Online Form
Other Forms (to be completed at any point in treatment):
INSURANCE AND FEES:
We accept most insurances, as well as, some sliding scale cases. Our office staff will check your insurance benefits for you as a courtesy. It is your responsibility to check and understand your insurance benefits.