Client Rights Annual Update Form
Client Rights Annual Handout
Patient Information Form
New Client Service Orientation
Authorization for Treatment
MH/SA Treatment Agreement (OP Treatment Agreement)
Financial Agreement
Service Fee & Sliding Scale
Notice of Privacy Practices
No Income/Cash Only Verification
Financial Intake Letter
ROI - MCO/CCNC/My Health Insurance
ROI - NCTOPPS/GPRA
ROI - Primary Care Provider
ROI - Emergency Contact
ROI - U.S. Federal Probation/Probation Officer
ROI - County Probation
ROI - Legal Guardian
English: Parent/Guardian | English: Foster Parents | English: Guardian Ad Litem
Spanish: Parent/Guardian | Spanish: Foster Parents
ROI - Schools
ROI - Department of Social Services
ROI - MAKO Medical
ROI - Medicaid Transportation
ROI - Nursing Home / Assisted Living / Group Home
ROI - Family Friends
ROI - Attorney
ROI - Blank Form