Mental Health ITP Signature Page – Client Self-Service – GForm

Use this form to acknowledge participation in the development of your service plan. 
Once you complete this form, you’ll be taken to a new page to sign it.

Use this form to document your consent for the individual service plan.
  • MM slash DD slash YYYY
  • This may be the client, or the parent/guardian.
  • This may be the client or the parent/guardian. A signed copy of this authorization will be sent to this email.
  • This field is for validation purposes and should be left unchanged.