Forms
PROTECTION OF PERSONALLY IDENTIFIABLE INFORMATION:
These forms in their uncompleted state are made available for the convenience of downloading and printing.
Sending any form in this list by electronic means (email, text messaging, sending photographs of the forms, etc.) after any personal data is entered is strictly prohibited.
Postal mail and fax are safe and appropriate methods for sending these forms after personal data is entered. You may also request to upload a completed form to an authorized, secure portal where PII is protected. To learn about this option, contact Your Amazing Journey, LLC.
SSW Program application forms:
(For completion after an intake appointment.)
Forms and Documents for Current Participants:
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POLICIES & ASCKNOWLEDGMENT FORMS
YAJ SSW Communication Policy – Revised 03/24/2024
YAJ SSW Communication Policy Acknowledgment Form – Revised 03/24/2024
P2P SMS Policy and Consent – Revised 03/24/2024
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RELEASE OF INFORMATION FORMS
SSA Consent for Release of Information (SSA-3288)
YAJ SSW Release of Information
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PROGRESS CHECKLISTS
