Checklist for Home Visit  

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As part of our ongoing construction, this page will be put in better form in the near future. Please note, too, that a downloadable document with (almost) the same information as appears below is available at
this link
. We apologize for any inconvenience.

In preparing for your home visit, make sure you read our description of the home visit.

Please plan for all of the following materials to arrive at our office at least two days before the scheduled home visit:

_____  Phone communication with all parties to custody (both parents in intact families)

_____  Service Agreement  completed

 _____ Service Agreement Addendum completed (if changes were made to the original Service Agreement)

 _____   Authorization to Release Information form completed

 _____   FamilyLight  Fact Sheet completed

 _____   Consulting fee paid by credit card, wire transfer, or personal check

 _____   Copies of clinical and academic records.  Please do not send originals..

 _____   A short biography of the young person's life, written by the parents (Please include significant events from infancy to the present as well as your impressions about the current problems.)

 _____   Put releases in place with doctors, therapists, schools, and programs so that Tom or an associate may speak with them regarding your son or daughter

 ____   Airfare, if applicable: When travel expenses involve airfare, the airfare and a possible booking fee must be paid by credit card several days prior to the home visit.  Contact us for instructions on faxing a Credit Card Authorization form to us.  Other expenses, such as hotel and car rental, will be billed after the home visit.

            Note:  (1) "Change fees" are likely to be applied when a purchased ticket is changed; these fees are the responsibility of the client  if the client has initiated the change.   (2) We regret that we cannot use frequent-flier tickets, complimentary tickets, or tickets purchased from Internet web sites.

To have the above information arrive on time, you may fax it to 775-890-0597


Send it Overnight  (if necessary) for weekday arrival to -           


                        Thomas J. Croke and Associates, Inc

                                    645 E. Pittsburgh Street, #334

                                    Greensburg, PA 15601


Call if you need weekend delivery information.

Please call us with any questions.

Reviewed for revision June 24, 2008

"Solutions, Not Just Referrals"

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