DHS Forms

We provide complete psychological evaluations for children between the ages of 12 months and 18 years of age who are in DHS custody/guardianship.

We will complete parent/child and/or sibling interactions in the context of a full psychological evaluation on either a parent or a child. Psychological evaluations of a parent will include a full parenting evaluation.

To initiate a psychological evaluation at the Children’s Program:

  • Please use the downloadable DHS Evaluation Request Forms available here:
    • Child Evaluation Request: PDF/Word format. (No other forms are needed) Fillable PDF – Download before filling out.
    • Adult Evaluation Request: PDF/Word format. (No other forms are needed)
  • Download the form to your desktop before filling it out. Filling it out online will not save your information.
  • Complete one form for each person to be evaluated
  • Save file once completed.
  • Email the file as an attachment to mwood@childrensprogram.com. using DHS secure email.

You will be contacted with a tentative date/time for the evaluation.  Please then confirm the appointment via phone or email.
Upon confirmation, a packet of forms will be mailed to you.  We ask that you complete and return these forms prior to the scheduled evaluation.

These forms must be completed and either mailed or brought to the office:

6443 SW Beaverton Hillsdale Hwy
Suite 300
Portland, OR, 97221

If you have any questions about completing these forms, please call our office 503-452-8002 x 133

Please note, some of these forms require Adobe Acrobat to display and print