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Groff & Associates

Forms

Adults

Minors

General

Church

Intake Form – Adult

Adult Self-Assessment

Consent for Clinical Treatment

Notice of Privacy Practices

Intake Form – Minor

Minor Self-Assessment

Agreement for Minor Children

Consent for Clinical Treatment

Notice of Privacy Practices

If you need to authorize your clinician to have access to give or receive your health information, Authorization to Release Information

Church Assistance Program – Authorization Form

Church Assistance Program – Release Form

Have questions? Contact Us

Click here for directions:  7425 East 86th St. Indianapolis, IN 46256
Main Number: 317-474-6448
| Fax: 317-468-9905

© 2026 Groff & Associates.

  • Home
  • Specialties
    • Men
    • Women
    • Relationships
    • Family
    • Children
    • Young Adult
    • Christian
    • Programs/Groups
  • Meet Our Team
    • Clinical
      • Cathy Appleton
      • Tori Bonar
      • Karla Calumet
      • Allison Chen
      • Dyrek Chowning
      • Ashley Dugan
      • Rachel Duke
      • Ríana Golder
      • Sally Groff
      • Macie Isley
      • Scott Jones
      • Mac McCollom
      • Michael Perry
      • Lynn Rubino
      • Carlyn Smith
      • Emily Turner
      • Jacob Zuluaga
    • Business
      • Jennifer Gates
      • Jess Hodge
      • Mark Groff
      • Sally Groff
  • Client Resources
    • FAQ
    • First Visit
    • Forms
    • Who We Are
    • Community Support
    • Church Assistance Program
  • Contact Us
  • Client Portal