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Child and Family Agency

Child and Family Agency

Strong | Safe | Supported

  • Services
    • Counseling
      • Child Guidance Clinic
      • Adult Outpatient Treatment
      • Open Access Hours
      • Community-Based Services
    • Urgent Crisis Center
    • School-Based Health Centers
      • Enrollment
      • Where we Operate
    • Community Bridge Clinic
    • Supportive Services
      • EARLY CARE And EDUCATION
      • Early Childhood Mental Health Consulting Program
      • Child Welfare Programs
      • family resource Centers
    • Forms
    • Billing and Insurance
      • Husky 4 Immigrants
    • Pay Your Bill
    • Patient Portal
    • Telehealth
  • About
    • Mission & History
    • Leadership
    • Advocacy
    • Other
      • Press Releases
      • 2022 Annual Report
      • 2022 Impact Report
      • 2021 – 2022 Audit
      • 990
      • CT State Single Audit
      • 2022-2024 Strategic Plan
      • Our Affiliations
  • Contact
    • Locations
    • Press Inquiries
  • Careers
  • Events
  • Donate
    • Legacy Giving
    • 2023 Event Sponsorship Opportunities

Descargar e Imprimir Formularios


Por favor descargue, imprima y complete (si corresponde) cada formulario incluido en esta lista antes de su cita de inscripción. Un miembro del personal lo revisará y es posible que se le solicite editar cualquier formulario que requiera una corrección. Si prefiere completar los formularios en línea, siga este enlace. https://www.childandfamilyagency.org/forms/forms-cita-de-admision/

Declaracion de custodia, solicitud de servicio y acuerdo de servicio
Procedimiento de Quejas
Salud Conductual, Psiquiatria, Y Servicios Medicos Politicas De Asistencia
Derechos Y Responsabilidades Del Cliente
Aviso sobre las prácticas de privacidad
Divulgacion de informacion de salud y asignacion de beneficios
Acuerdo De Responsabilidad Financiera
Consentimiento Y Aviso Relacionado A Las Firmas Electronicas
Consentimiento informado de telesalud
Authorizacion Para El Intercambio De Informacion De Salud (HIE)

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