CARE Network Participation Form

Consent form must be completed by parent/guardian/legal custodian in order to be eligible for reimbursement and qualify as a CARE Network assessment.

The Child PTSD Symptom Scale for    DSM-V

Screening measure to evaluate presence of  trauma symptomology and/or a diagnosis of PTSD

PHQ-9

(modified for  adolescents- PHQ-A)

Screening measure to evaluate presence of depressive symptomology and/or a diagnosis of Depression

Screen for Child Anxiety Related Disorders (SCARED)

Screening measure to evaluate presence of anxiety symptomology and/or diagnosis of Anxiety

Decision Tree for Adjunctive Measures

Recommendations for additional screening measures based on positive screens in the PTSD, PHQ-A or SCARED measures

EXAMPLE- Child Intake Form

Here is an example of an intake form that CU’s trauma team uses

The Therapist Tool Box

Flyer that provides information on a CARE Network Behavioral Health Intake, what families can expect, how to talk to children, etc. Download here.

A Flyer for Families: A CARE Network Behavioral Health Intake

Flyer that provides information on a CARE Network Behavioral Health Intake, what families can expect, how to talk to children, etc. Download here.

CARE Network Referral Form

A suggested template for communication between DHS and CARE Network Provider