forms

Links to HIPAA-compliant secure forms

Forms for clients & families

Upload documents — to securely upload documents for us to review.
Release of Information — to be used to allow us to contact others in regards to your care.
Winston Center Privacy Practices — for HIPAA related information

Forms for teachers

The forms listed below are for teachers to provide us with information on how your child is performing at school.

Teacher Initial Questionnaire – To be done the first time the teacher completes a questionnaire for a
particular student. At subsequent times, use the Follow-Up Questionnaire.

Teacher Follow-Up Questionnaire – For follow-up questionnaires you do not need to complete all fields, just those you feel are pertinent.

insurance

We are in net-work with the following insurance companies:

Premera

Blue Cross/ Blue Shield (regence)

Ameriben

First Choice Health

Asuris

Kaiser PPO

If you do not have the insurance listed above, you may have out-of-network benefits. Call your insurance company to verify benefits. Out of network patients are considered self-pay and payment in full at time of service is required.