Child Mental Health Intake Paperwork

Please click on each box below, save to your computer, complete, save again and attach to email

tip: check your saved document after completing it to ensure the information saved

Adult Mental Health Intake Paperwork

Please click on each box below, save to your computer, complete, save again and attach to email

tip: check your saved document after completing it to ensure the information saved

Center for Prevention of Family Violence Intake Paperwork

Please click on each box below, save to your computer, complete, save again and attach to email

tip: check your saved document after completing it to ensure the information saved

Read only documents

If you would like your child's therapist to communicate with a 3rd party, like a school staff or a pediatrician, please fill out the release of information form. It is optional.

Couples Therapy Intake Paperwork

Please click on each box below, save to your computer, complete, save again and attach to email

tip: check your saved document after completing it to ensure the information saved

Professional Affiliations

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PROHEALTH CARE

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WAUKESHA CLINIC &
ADMINISTRATIVE OFFICES

101 W. Broadway, 2nd Floor Waukesha, WI 53186 

 

Email: info@fswaukesha.org

Phone: 262.547.5567

THE BIG YELLOW HOUSE 

726 N. East Avenue 

Waukesha, WI 53186

 

Children's Place Clinic 

Phone: 262.544.9622

 

The C.A.R.E. Center 

Phone: 262.522.3680 

OCONOMOWOC CLINIC 

175 E. Wisconsin Avenue, Suite H

Oconomowoc, WI 53066

 

Phone: 262.567.4455 

 

BILLING SERVICES 

Phone: 262.522.6439 

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