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Home
FORMS
OUR TEAM
LOCATIONS
  • POWDERSVILLE LOCATION
  • GREER LOCATION
More
  • Home
  • FORMS
  • OUR TEAM
  • LOCATIONS
    • POWDERSVILLE LOCATION
    • GREER LOCATION
  • Home
  • FORMS
  • OUR TEAM
  • LOCATIONS
    • POWDERSVILLE LOCATION
    • GREER LOCATION

Our Forms Can Be Completed Online For Your Convenience

The following online forms are HIPAA compliant and automatically upload to a secure network when complete (with exception to the injectable enrollment forms). No downloading or uploading necessary. If you have any questions/concerns, please give us a call. Thank you!

NEW CLIENT PAPERWORK

INTAKE PAPERWORK (OUD)

INTAKE PAPERWORK (SEMAGLUTIDE)

INTAKE PAPERWORK (OUD)

MAT - Opioid Use Disorder

COMPLETE FORM HERE

INTAKE PAPERWORK (AUD)

INTAKE PAPERWORK (SEMAGLUTIDE)

INTAKE PAPERWORK (OUD)

MAT - Alcohol Use Disorder

COMPLETE FORM HERE

INTAKE PAPERWORK (SEMAGLUTIDE)

INTAKE PAPERWORK (SEMAGLUTIDE)

INTAKE PAPERWORK (SEMAGLUTIDE)

Weight Loss

COMPLETE FORM HERE

OFFICE FORMS

RELEASE OF INFORMATION (ROI)

RELEASE OF INFORMATION (ROI)

RELEASE OF INFORMATION (ROI)

This is required for records requests, coordination of care, etc. 

COMPLETE FORM HERE

SUBLOCADE ENROLLMENT

RELEASE OF INFORMATION (ROI)

RELEASE OF INFORMATION (ROI)

*Please Do Not Complete Unless Directed By A Staff Member*

COMPLETE FORM HERE

VIVITROL ENROLLMENT

VIVITROL ENROLLMENT

VIVITROL ENROLLMENT

*Please Do Not Complete Unless Directed By A Staff Member*

COMPLETE FORM HERE

BRIXADI ENROLLMENT

VIVITROL ENROLLMENT

VIVITROL ENROLLMENT

*Please Do Not Complete Unless Directed By A Staff Member*

COMPLETE FORM HERE
  • FORMS
  • OUR TEAM
  • POWDERSVILLE LOCATION
  • GREER LOCATION

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