These are the forms used by CAPS to initiate treatment, obtain or release records, and bill insurance. Use the boxes below to find the forms you're looking for:
When a student is a minor, we need the following forms completed by a parent/guardian for CAPS treatment. Please also review our instructions for accessing services for students who are under 18.
Forms:
The following forms are used to give CAPS permission to request or release your records:
CAPS Authorization for Release or Request of Information (Allows CAPS to RELEASE information to/REQUEST information from an outside provider)
Consent Form for ADHD Evaluation
Find out more about our ADHD Services.
The Consent to Bill Insurance & Consent for Treatment (English) form has been translated to Arabic and Mandarin Chinese.
Patients will still be asked to sign the English form version during their visit.
Consent to Bill Insurance & Consent for Treatment (Arabic)
Consent to Bill Insurance & Consent for Treatment (Mandarin Chinese)
CAPS Authorization for Release or Request of Information (Allows CAPS to RELEASE information to/REQUEST information from an outside provider)
Consent to Bill Insurance & Consent for Treatment (English)
Consent to Bill Insurance & Consent for Treatment (Arabic)
Consent to Bill Insurance & Consent for Treatment (Mandarin Chinese)
Consent Form for ADHD Evaluation
Form Submission & Questions
Follow the direction of your CAPS provider for any form submissions. Forms can typically be sent to a provider by secure message attachment through PatientLink.
For questions, please contact CAPS at 520-621-3334 during business hours.