Partnership papers

Clarity, care, and consent—without a maze.

Intake, consent, privacy, the family agreement, and attendance keep the partnership honest. You can fill them here, or we can finish them together. Missing papers should never keep you from showing up.

Every journey begins with hope.

Begin your journey

Why these papers exist

Each form has a human job.

They are not a test, and they are not a commitment to a weekly package you have not agreed to. They help ROSE begin with your story, your yes, and a clear way to protect reserved time.

Client Intake

Your story, in your words: history, communication, and the goals that bring you here. Bring what you have.

Open intake

Consent for Evaluation & Treatment

A clear yes before evaluation or therapy begins. Nothing starts until you agree.

Open consent

HIPAA Privacy & Release

How privacy works, and who ROSE may speak with—school, physician, or EI—only when you authorize it.

Open privacy & release

Therapy Expectations & Family Agreement

The partnership promise: what ROSE holds, and what families hold, so the work can live at home.

Open family agreement

Cancellation & Attendance

How reserved time is protected. The only fee published on this site is $25 for a late cancel or no-show, unless waived, when less than 24-hour notice is given.

Open attendance policy

How to complete them

Together is always an option.

Complete a form in the browser, save a draft on this device, print a PDF, or email a summary to the practice
We can finish papers together on a call or at the first visit
Missing papers should never keep you from showing up
Prior reports, IEPs, and hospital notes are helpful when you have them—never required to call

Open the form list Start with intake First visit Finish them together

What this is not

Clear limits protect families.

These pages are not legal advice. Please review privacy and consent language with your own counsel as needed.
The Speech-Language Evaluation Report is J'Vohnne's clinical template. Families do not fill it out.
Papers are not a commitment to a weekly package you have not agreed to. Fees are named before evaluation or therapy begins.
A signed release is required before ROSE shares progress with a school, physician, or EI team. Meeting attendance is not assumed.

Notice of privacy practices Records & sharing

A conversation is enough

Call first if the papers feel heavy.

You do not need a referral to start. You do not need every prior report. Fees are named before evaluation or therapy begins.

Call 773-457-1204 Start here The first conversation After evaluation Request an appointment

Every bloom begins with ROSE.