PATIENT FORMS TO BEGIN
OPIOID DEPENDENCE TREATMENT

Patient Forms

Opioid dependence treatment is very delicate, and we want to make sure that we obtain all of the information needed to create the best treatment plan possible. If you are a new patient at our clinic, please print and complete the following forms and bring them with you to your appointment in order to ensure that all of your documentation is processed quickly and effectively. Thank you.

If you have any questions, please Contact Us!

PHARMACY CONSENT FORM

NEW PATIENT DEMOGRAPHICS FORM

NURSING INTAKE FORM

This is Where

I CHANGE MY STORY

A healthier life is waiting for you.
Are you ready to change your story?

Contact Us