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Please list names, relationship to youth and age.
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THIS SECTION IS TO BE COMPLETED BY YOUTH AGE 13 AND OVER
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Age at first use and last time used
Confidentiality and Disclosure of Client: The CHINS Treatment Team (CTT) is a collective body with members representing court employees and other vetted external agencies including (but not limited to) School Social Workers, DFCS and Family Ties, Inc. The CHINS Coordinator may make referrals to outside agencies, community organizations and/or consulting mental health professionals as necessary.
As Mandatory Reporters, the law authorizes us to disclose confidential information in certain circumstances without the consent of the client or client's authorized representative. These circumstances include cases in which an individual is deemed a danger to self or others or if there is suspected abuse and/or neglect.
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