Acumen Brochure
Printable brochure to share with referrals, as needed to describe and outline services offered.
Acumen Diary Card
DBT Diary card for Acumen Counseling Services clients.
Acumen Referral Form
Referrals for services from other providers are facilitated more quickly with this form.
Acumen Release of Information Form
The release of client information requires a written release of information.
Acumen Information Packet
This booklet contains important information, including:
Information for Therapy Clients
Confidentiality in Therapy
HIPAA, Records and other Privacy Practices
Access to Health Records Notice of Rights
Minnesota Patients’ Bill of Rights
Adult Intake Packet
This packet contains a ‘Client Data Sheet ‘ to gain demographic information for minors, ‘Informed Consent to Treatment for Therapy Clients’, and an ‘Acknowledgement of Privacy Practices, HIPAA, Records other Privacy Practices’ form which must be completed prior to the first session.
Minor Intake Packet
This packet contains a ‘Minor Data Sheet ‘ to gain demographic information for minors, ‘Informed Consent to Treatment for Parents of Minor Therapy Clients’, and an ‘Acknowledgement of Privacy Practices, HIPAA, Records other Privacy Practices’ form which must be completed prior to the first session.