ASIAN PACIFIC COUNSELING AND TREATMENT CENTERS
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APCTC FORMS

These documents recently have been updated.  Translations to other languages will be available soon.  

CONSENT FORMS

  • Consent Form - English
  • Consent Form - Korean
  • Consent Form - Spanish
  • Consent Form - Traditional Chinese

WELCOME PACKET

  • ​APCTC Welcome Packet - Chinese
  • APCTC Welcome Packet - English 
  • ​APCTC Welcome Packet - Korean
  • ​APCTC Welcome Packet - Spanish​

PROTECTED HEALTH INFORMATION AUTHORIZATION

  • PHI Authorization - Khmer
  • ​PHI Authorization - Korean
  • PHI Authorization - Simplified Chinese
  • ​PHI Authorization - Spanish
  • PHI Authorization- Traditional Chinese
  • PHI Authorization - Vietnamese

NOTICE TO PSYCHOTHERAPY


STUDENTS

  • Notice to Psychotherapy Clients - English
  • Notice to Psychotherapy Clients - Korean
  • Notice to Psychotherapy Clients - Simplified Chinese
  • Notice to Psychotherapy Clients - Spanish
  • Notice to Psychotherapy Clients - Tagalog
  • Notice to Psychotherapy Clients - Traditional Chinese
  • Notice to Psychotherapy Clients - Vietnamese

REGISTERED

  • Notice to Psychotherapy Clients - English
  • Notice to Psychotherapy Clients - Korean
  • Notice to Psychotherapy Clients - Simplified Chinese
  • Notice to Psychotherapy Clients - Spanish
  • Notice to Psychotherapy Clients - Tagalog
  • Notice to Psychotherapy Clients - Traditional Chinese
  • Notice to Psychotherapy Clients - Vietnamese

LICENSED

  • Notice to Psychotherapy Clients - English
  • Notice to Psychotherapy Clients - Korean
  • Notice to Psychotherapy Clients - Simplified Chinese
  • Notice to Psychotherapy Clients - Spanish
  • Notice to Psychotherapy Clients - Tagalog
  • Notice to Psychotherapy Clients - Traditional Chinese
  • Notice toPsychotherapy Clients - Vietnamese
Updated 09/12/2025

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  • HOME
  • ABOUT US
    • History and Mission
    • APCTC Staff
    • APCTC Leadership
    • APCTC Advisory Board
  • PROGRAMS & SERVICES
    • Enrolling in Services
    • Program Brochure
    • Media
    • Blog
    • FAQS
    • Resources
  • EVENTS
    • Los Angeles County Events
    • Riverside County Events
    • Art Showcases >
      • 2025 Art Showcase
      • Past Art Showcases >
        • 2024 ART SHOWCASE - Collaboration in The Journey of Healing
        • 2023 ART SHOWCASE - This is MY VOICE
        • 2022 ART SHOWCASE - Make a Difference Together
        • 2021 ART SHOWCASE - Journey of Healing
    • Archive
  • JOIN US
    • Employment Opportunities
    • Training Opportunities
  • FORMS
    • APCTC FORMS
    • LACDMH FORMS
  • CONTACT US
  • DONATE