Forms
Spero — or a specific therapist or mental health professional — will often ask that you complete certain forms prior to your appointment. They may be needed for insurance purposes, privacy, or to help us better address your mental health or therapy needs.
We’ve provided several forms online to save our therapy clients time in the office. All forms are located below in either PDF format to print and sign — which requires Mental Health Family Counseling Resources MN to view — or online versions, which can be completed and submitted electronically.
Please note, filling out these forms does not make you a client of Spero, you must call to set up an appointment at 507-451-2630 or 800-722-0590.
New Client Appointment Forms
Notice of Privacy Practices
New Client Questionnaire – Adult
New Client Questionnaire – Child and Adolescent
SDOH – Adult
SDOH Child & Adolescent
Insurance and Agreements Form
Release of Information
Telehealth Services Consent
Client Profile Form
PHQ-9 – Depression Screening – 18 & Older
PHQ-9A – Depression Screening – 12-17 Years Old
GAD-7 – Anxiety Screening – 12 years and Older
Vanderbilt ADHD Diagnostic Rating Scale – Parent (when appropriate)
Vanderbilt ADHD Diagnostic Rating Scale – Teacher (when appropriate)
Teletherapy/Telehealth Forms
Therapy Treatment Plan Signature Form
Therapy and Psychiatry – Staff Rights and Responsibilities
Group Teletherapy Confidentiality Agreement
Psychiatry – Consent to Obtain Medication History
Adult Mental Health Targeted Case Management (ATCM) Treatment Plan Signature Form
ARMHS Telehealth Signature Form
CTSS Telehealth Signature Form
Housing Programs Telehealth Signature Form
Children’s Mental Health Targeted Case Management (CTCM) Signature Form
Student Observation
Online Release of Information Forms
Referral Forms
Dialectical Behavior Therapy (DBT)
Substance Use & Recovery
Authorization to Disclose Protected Health Information
Client Notice of Assessment Fee & Financial Responsibility
Confidentiality and Adult Protection Reporting
DAANES Acknowledgement Form
DRP Observation and Treatment with Intern Informed Consent
Adolescent Program Specific
Referral for Adolescent Substance Abuse Program
Safe Harbour
Crisis Response
Printable Forms
Release of Information
Directions for filling out a Release of Information form
Insurance Release
Consent to Obtain Medication History
Client Request to Obtain Personal Health Information
Supporting your recovery
At Spero, we understand a substance use disorder does not mean an individual is morally weak or lacks self-control and that recovery is not as simple as resisting the urge to use a substance. Our experienced team of professionals provide support and guidance to help you identify what recovery looks like for you. Spero provides a continuum of care that promotes valuing and empowering people to minimize substance use related harm and enhance the quality of not only their lives but their families and communities.
An integrated approach to well-being
Substance use and recovery programs focus on treating individuals who face mental health and substance use disorders. This integrated approach acknowledges the relationship between mental health conditions and substance use disorders, ensuring that both are addressed concurrently for more effective outcomes.
Personalized treatment plans
We believe in the power of personalized care. Our dual recovery programs are tailored to each individual’s unique needs, taking into account their specific mental health issues, substance use patterns, and personal circumstances. This customized approach helps us deliver more targeted and effective treatment.
Comprehensive therapy options
Our therapy options encompass a wide range of trauma informed evidence-based practices, including Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) skills, Seeking Safety, and Motivational Interviewing (MI). These therapies are designed to teach individuals how to be resilient and overcome barriers related to their mental health and substance use. Individuals will develop effective coping strategies and have the ability to use those strategies with support.
Peer support services
Peer support services play a crucial role in substance use and recovery programs. A peer support specialist is a person in recovery that walks side by side with someone on their recovery journey. At Spero, peer support services promote self-determination, personal responsibility, and empowerment.
Integrated medical and psychiatric care
Effective treatment requires a coordinated approach that may include medical and psychiatric care. Our team of medical professionals and psychiatry providers work together to ensure that individuals receive comprehensive care, including medication management and medical support.
Integrated services
We understand recovery means more than a change in substance use, but also improving overall wellness. To address wellness needs, we have individuals assess their mental, nutritional, physical, emotional, social, occupational, and spiritual health. Our staff will assist individuals in providing resources or locating resources to help them achieve their identified goals.
Family involvement and education
Family support can significantly impact recovery outcomes. We involve family members in the treatment process and provide them with education on co-occurring disorders. This helps to create a supportive home environment and fosters a better understanding of the challenges faced by their loved ones.
Recurrence prevention
We equip individuals with strategies and tools to recognize and manage triggers, build resilience, and maintain their recovery long-term. Our goal is to empower clients to sustain their progress even after completing our program.
Ongoing aftercare and support
Recovery is a lifelong journey, and our commitment to our clients extends beyond their time in our program. We offer ongoing aftercare and support services, including follow-up sessions, continued access to support groups, and resources for continued personal growth and recovery.
Outcome monitoring and continuous improvement
We continuously monitor the outcomes of our substance use and recovery programs to ensure they meet the highest standards of care. By collecting and analyzing outcomes and feedback, we can identify areas for improvement and make evidence-based adjustments to our treatment approaches, ensuring the best possible care for our clients.