Some standards have forms that are referenced in the Table of Evidence. You can find them in your MyCOA account or on COA’s website.

When a form is required, you can use the form provided or attach an existing form in lieu of this document, provided that it captures all of the information requested in the form.

Forms Description
Collaborative Relationships Profile This form is used to provide information about the adoption service providers you partner with in Convention cases. You will need to include contact information for each provider. You will also need to indicate what role each provider takes on when you work on Convention cases together (e.g., primary provider, supervised provider, or exempt provider). You will need to include information about domestic and foreign partners on this form.<br />
Governing Body Profile This form is used to provide information about the members of your Governing Body/Advisory Group. This form is NA for individual practitioners seeking approval.<br />
Employee Profile This form is used to provide information about employees who are involved in the provision of services in Convention cases.<br />
Executive Verification Statement This form is used by your Executive Director and Governing Body Chair to disclose certain information, as required in the standards. This form must be notarized.<br />
State Licensing and Regulatory Profile This form is used to provide information about the state licensing rules or other regulations that apply.<br />


Private Organization Accreditation

Northside Psychological Services is a combination of both private practice and community mental health provider. We provide services to children and adults (EAP, private insurance, private pay, etc.) in our private practice setting. In our Community Care Program, we provide services to children and adolescents in their homes.


Holy Family Institute

Sister Linda Yankoski, President/CEO

The Council On Accreditation provides all stakeholders involved in the delivery of social services the assurance that the organization is credible, effective, and is committed to quality improvement. The COA process is an important tool for anyone involved in leading an organization to establish best practices and maintaining and updating these practices over time.
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