Andrews Center
Behavioral Healthcare SystemClick here to learn more About UsClick here to Contact UsClick here to learn about Employment opportunitiesClick here to learn about Volunteer opportunities

We're here for you.....

 

In an effort to make things a little easier we now have our forms available online.

 

There is no need to download. Simply click on a link below, type in the fields provided, print it out and bring them with you to your appointment. It's that easy!

 

If you aren't sure which form you need to complete please feel free to give us a call.

 

Forms
(Click on the Word or PDF Icon to open form)

Document Title

 

Word PDF

Authorization for Release Obtaining Information

 

 

Family and Physician Release

 

 

Fee Assessment

 

 

Insurance Benefits Assignment

 

 

Privacy Practices Notice

 

 

Privacy Practices Notice

(Spanish - versión en español)

 

Receipt of Privacy Practices

 

 

Registration

 

 

TCOOMMI Registration

 

 

Notice Concerning Complaints

 

 

 

 

 

 

 

 

 

 

 

 

 

Access - Forms