The Parent & Child Wellness Center
Your resource for tools, strategies, and healing for you and your family
All the forms below can be electronically signed and sent back to mkrtherapiesct@gmail.com.
Signing forms electronically is different on every device. For a newish Droid phone, you can simply click on the form PDF icon and then click on the little marker button fill in areas needed to be filled in. For an Apple phone, Apple desktop, Apple MacBook, or an iPad the simplest way, after clicking on the PDF icon of your choice, may be to share the file to "Books" viewer, then sign the documents.
Once the forms are signed email them back to mkrtherapiesct@gmail.com
If you have any question email mkrtherapistct@gmail.com or reach out on FaceBook messenger
New Client Form
Informed consent to child psychotherapy form
Mandated Reporter Form
Email consent form
Zoom meeting informed
consent form
In-home child psychotherapy
liability waiver
Getting Started Child Therapy Forms
The Break Space Forms
This form only needs to be filled out once for access to all the "Break Space" events.
Liability Waiver
Getting Started Parent Coaching Forms
For Parent coaching, Enlightened Parent Series or the Breathing Room
New Client Form
Parent Coaching informed consent form
Mandated Reporter Form
Zoom meeting informed
consent form
Yoga and Mindfulness Forms
Liability Waiver