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Multi-ethnic Group of Friends Practicing Emotional Regulation in a Group Setting

Client Forms

New Client Forms

Please complete the digital forms below prior to the first session.

For those interested in our after school programs, please complete our Client Information Application Form to provide us important information regarding your child. 

To ease our scheduling process, please fill out the Session Availability Form and provide as many possible dates and times that align with you and your child's schedule. Accuracy on this form is crucial for students that want to partake in group learning programs. 

Please complete the Social Skills Checklist Form to provide information regarding your child's strengths and desired areas of growth. This checklist will help establish what social skills need extra focus throughout our after school programs. 

Permissions/Consent forms below must be printed, signed, and returned prior to the first session.  Contact us if you would prefer these mailed to your home.

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(920) 619-2945

Service locations in Kewaunee County, Wisconsin

Luxemburg-Casco Primary School: Monday, Tuesday, Wednesday.

Zion United Methodist Church: Saturdays.

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