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Intake Packet for Substance Abuse Treatment

Please download and complete these forms. Bring the completed paperwork to the first appointment.

Click here to download:
Our Client profile for Personal, Insurance and Financial information

Click here to download:
Our Disclosure Agreement

Click here to download:
Infectious Disease Risk Assessment Form

Click here to download:
Our No-Show Policy

Click here to download:
Emergency Contact Information

Click here to download:
Insurance Release Form


Intake Packet for Mental Health Counseling

Click here to download:
Our Client profile for Personal, Insurance and Financial information

Click here to download:
Our Disclosure Agreement

Click here to download:
Client Personal Profile

Click here to download:
Our No-Show Policy

Click here to download:
Emergency Contact Information

Click here to download:
Insurance Release Form

 

 

 

 

 

 

 
 


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Ashland, Oregon Office: 611 Siskiyou Blvd. Suite 8 - 541-482-1718 - Medford, Oregon Office: 111 Genessee Street - 541-779-5866