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  • Mental Health
    • Adult Counseling
      • ARMHS
      • Substance Use & Recovery Services
    • Integrative Healthcare & Wellbeing
    • Depression & Anxiety Treatment
    • Youth and Family Counseling
      • ADD/ADHD
      • Mood or Behavior Disorders
      • Trauma Treatment
      • Psychiatric Evaluation
      • Substance Use & Recovery Services
    • Community Support
    • Crisis & Residential Services
    • Telehealth
  • Substance Use
    • Detoxification
    • DUI Education
    • Counseling
    • Drug Testing Services
    • Support Groups
  • Medication Management
    • ADD/ADHD
    • Anxiety & Depression
    • Bipolar Disorder
    • Obsessive Compulsive Disorder
    • Post Traumatic Stress Disorder
    • Schizophrenia
  • Your Visit
    • What To Expect
    • About Us
    • Locations
    • Insurance Accepted
    • Client Forms
    • Make A Referral
  • Providers
    • Meet The Team
    • Leadership and Staff
    • Licensing and Certifications
    • Make A Donation
    • Annual Report
  • Resources
    • Classes & Groups
    • Types of Therapy
    • Teachers & Parents
    • Video Resources
    • FAQs
    • News

School-Linked Mental Health Form

School-Linked Mental Health Form

Home ยป School-Linked Mental Health Form
  • Zumbro Valley Health Center Kingsland School-Linked Mental Health Form

    Zumbro Valley Health Services will offer mental health care to students at Kingsland School District. Services will include care for a variety of mental health needs, along with the provision of chemical dependency evaluations. Services will be provided in individual, group, and family formats, depending on the student's individual needs. If a student has insurance coverage, a claim may be generated for the service that is provided at Kingsland School District. If a referral is made for more intensive services at Zumbro Valley Health Center offices, the student and parent will be required to do a formal intake with the Customer Service staff to initiate services. In order for your child to receive mental and chemical health care from the Zumbro Valley Health therapist, the following form must be completed and signed. Per MN statute 144.343, a minor may give consent for medical, mental, and other health services to determine the presence of or to treat pregnancy, and conditions associated with venereal disease, and alcohol and other drug abuse.
  • Date Format: MM slash DD slash YYYY
  • Zumbro Valley Health Center Pine Island School-Linked Mental Health Form

    Zumbro Valley Health Services will offer mental health care to students at Pine Island School District. Services will include care for a variety of mental health needs, along with the provision of chemical dependency evaluations. Services will be provided in individual, group, and family formats, depending on the student's individual needs. If a student has insurance coverage, a claim may be generated for the service that is provided at Pine Island School District. If a referral is made for more intensive services at Zumbro Valley Health Center offices, the student and parent will be required to do a formal intake with the Customer Service staff to initiate services. In order for your child to receive mental and chemical health care from the Zumbro Valley Health therapist, the following form must be completed and signed. Per MN statute 144.343, a minor may give consent for medical, mental, and other health services to determine the presence of or to treat pregnancy, and conditions associated with venereal disease, and alcohol and other drug abuse.
  • Date Format: MM slash DD slash YYYY
  • Zumbro Valley Health Center Rochester Alternative Learning Center School-Linked Mental Health Form

    Zumbro Valley Health Services will offer mental health care to students at Rochester Alternative Learning Center. Services will include care for a variety of mental health needs, along with the provision of chemical dependency evaluations. Services will be provided in individual, group, and family formats, depending on the student's individual needs. If a student has insurance coverage, a claim may be generated for the service that is provided at Rochester Alternative Learning Center. If a referral is made for more intensive services at Zumbro Valley Health Center offices, the student and parent will be required to do a formal intake with the Customer Service staff to initiate services. In order for your child to receive mental and chemical health care from the Zumbro Valley Health therapist, the following form must be completed and signed. Per MN statute 144.343, a minor may give consent for medical, mental, and other health services to determine the presence of or to treat pregnancy, and conditions associated with venereal disease, and alcohol and other drug abuse.
  • Date Format: MM slash DD slash YYYY
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Zumbro Valley Health Center