DHS Forms

As of March 17th we are no longer accepting DHS referrals due to the Covid19 outbreak. If you have any questions please direct them to Michael Wood at mwood@childrensprogram.com.

DHS Portal Link

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 DHS Evaluation Request Forms available online:
    • Child Evaluation Request: DHS Child Evaluation Request Online Form
    • Adult Evaluation Request: DHS Adult Evaluation Request Online Form
  • Complete one form for each person to be evaluated
  • If you have questions please email  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 submit 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