Online Intake Forms

Easily Access our services by calling 1-800-511-5446, or walk into one of our offices near you. No hassle, technology support available if needed.

 

If you need assistance with the forms or have questions, please call us or click the Help button below. 

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You may refer to the Forms on the left side of the page as you complete the Online Forms.

Authorization for Release of Information

Acknowledgement/Consent to Treat

Affidavit

PHQ-9 (Adults)

PHQ-A (Adolescent)

Consent for Medication

 

For assistance with other questions, please call us at 1-800-511-5446

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