Child/Minor Mental Health Screening Tools – GForm

Child/Minor Mental Health Screening

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  • Our electronic intake and consent forms utilize email communication for transmission of your information.

    Email and text messaging, while efficient, are relatively insecure.

    Please be informed that these methods, in the typical form, are not confidential means of communication. While we use encryption to secure the contents of emails sent between our webservers and your inbox, there is still a chance these communications, which may contain confidential information, could be intercepted.

    The kind the parties that may intercept these messages include, but are not limited to:

    • People in your home or other environments who can access your phone, computer, or other devices that you use to read and write messages.
    • Your employer, if you use work email to communicate with any employee of Tom Lutz and Associates.
    • Third parties on the Internet such as server administrators and others who monitor Internet traffic.

    We offer electronic documentation for convenience and to remove barriers to care. It is not a requirement to receive services. If you'd prefer not to utilize electronic documentation, please do not complete this form, and call us at 651-500-0905 to discuss alternative methods for completing this paperwork. 

    By proceeding past this page, and clicking the box below, you are acknowledging the risks explained above and agreeing to utilize our electronic forms and email communication.