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Here is a list of potential forms you may want to access related to services at WTC. If you are unable to open or access the forms please contact:

*Note: If you are completing forms on behalf of someone else, please know that we must verify information with the primary client (or legal guardian). 

Intake Forms for First Appointment


Screening Assessments

Depression: PHQ-9

Anxiety: GAD-7

Mood/Bipolar: MDQ

Trauma: PCL-5

Substance Use: CAGE-AID


Information & Record Requests


Referring Providers & Agencies

For providers and agencies wanting to refer a client to WTC, please complete the referral form & fax required information to 

(701) 552-7975.

For questions related to external referrals, please call (701) 730-8313 ext. 1.

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