Matt's Place

Forms

Patient Forms

We look forward to working with you and your family.
Once you complete the packet, please return it to our office. Our clinical team will review and contact you to schedule your childs intake appointment. 


This information is for children enrolled in either our Day Treatment Program or Intensive Outpatient Program. 
Please take time to carefully read and review the enclosed information.


This packet contains screening information to ensure that the group is an appropriate and good fit for everyone involved and will give the facilitator important information that will help them in teaching your child.
Please complete and return the following registration packet prior to the first group that your child will attend.


Please think about your child’s behaviors in the past 6 months as you complete this form.


Please think about this child’s behaviors since the beginning of the school year as you complete this form.