New CCD Client Forms – English
After you speak to a therapist or case manager, you can complete the following three forms via the internet. Your completed forms will be sent to the therapist or case manager you choose on the forms.
1. Choose one of these Registration forms:
Adult CCD Registration – English (Use this one if the primary client is an adult)
OR
Youth CCD Registration – English (Use this one if the primary client is a minor)
2. Client Information and Consent – English
3. Notice of Privacy Practices – English
If you are going to be seen virtually, you also need to complete this form:
CCD Telehealth Consent – English
Schedule Substance Abuse Assessment, IOP or SOP Intake – English
Use the following links to request an appointment for those three services:
Substance Abuse Assessment – English
Supportive Outpatient/Aftercare Intake Appointment – English