Take the Free Assessment - Choose Mental Health

Has your child completed high school?*
Has your child completed High School?
- Yes
- No

Is your child currently in therapy?*
Is your child currently in therapy?
- Yes
- No

Select where your child is currently residing?*
Select where your child currently residing?

Have you hired a consultant?*
Have you hired a consultant?
- Yes
- No
Consultant Disclaimer*
This Process cannot use out of network consultants
- Ok, I understand

Is your child addicted to substances ( drugs / alcohol )?Please Explain:*
Has your child had psychotic symptoms ( hallucinations / delusions )? Please Explain*
Hidden
You've indicated that you have attempted suicide. Please explain how recent and the circumstances*
Has your child been accused of a sexual crime? Please explain*
Has your child been violent / assaultive? Please explain*
Does your child have Reactive Attachment Disorder or attachment issues? Please explain*
Has your child been charged or accused of a crime? Please Explain*

Before submitting your assessment,
please accept our Terms & Conditions
I/we hold harmless Choose Mental Health and staff, leaders and/or associated agents, consultants, programs. I understand this service is for children and youth who need high levels of help for mental health needs and by continuing with this application will hold all parties harmless who are working on my behalf. Regardless of needs I /we understand many kids don’t need or don’t get placed even if it seems they should. If your child is placed you understand that your relationship is only with your program provider. Choose Mental Health does not direct or influence treatment in any way. You acknowledge that the information provided in this an other forms to Choose Mental Health will be emailed using standard email protocols with no extra protection layers or security.
Do you accept these Terms and Conditions?*
Do you accept these Terms and Conditions?
- YES