Butterfly

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Client Information & Consent Forms

  1. Authorization Consent for Use & Disclosure of Protected Health Information
  2. Biopsychosocial Assessment
  3. Credit Card Authorization from Client
  4. Eating Disorder Questionnaire - Adolescent
  5. Eating Disorder Questionnaire - Adult
  6. HIPAA Privacy Notice
  7. Journey Group Client Form
  8. New Client Information & Consent
  9. New Client Profile - Adolescent
  10. New Client Profile - Adult
  11. Parental Waiver of Right to Child's Records

 

Client Resource Forms

  1. Activity Log
  2. Anger Log
  3. Boundaries Made Easy - P.A.D. Formula
  4. Brain Connection
  5. Family of Origin Worksheet
  6. Food Plan
  7. Foundational Needs
  8. Hokey Cheesy Model for Assertiveness
  9. Meal Planning Worksheet
  10. Physical, Emotional & Spiritual Map
  11. Recovery Diary
  12. SMART Goal Progress Monitor

 

Client Inventory Worksheets

  1. Anger Inventory
  2. Depression Inventory
  3. Fear Inventory
  4. Grief & Loss Inventory
  5. Resentment Inventory

 

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