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New Admission Forms

Help Starts Here > Forms

Welcome to Community Reach Center! Your first meeting with us is called a "New Admission". Please click on What to Expect to understand what will take place at this meeting. We offer new admission meetings on a walk-in basis 5 days per week. Click on New Admission Schedule to find a time and location most convenient to you.

 

In preparation for your first Intake meeting with us, please take a few minutes to download and complete the forms below. You may find it easier to complete these forms at home where you have all your information available. However, if you are not able to print these, forms will be available when you arrive at one of our offices. Most forms are available in both English and Spanish.

 

Please use a black ink pen to complete the form and do not fill in the date on the form until you arrive for intake.

 

We look forward to seeing you soon!

 

Admission Form
(24 KB)
 

Admission Form (in Spanish)
(89 KB)
 

Consumer Financial Form & Fee Policy
(87 KB)
 

Consumer Financial Form (in Spanish)
(131 KB)
 

Fee Policy (in Spanish)
(40 KB)
 

Medical History Questionnaire English
(23 KB)
 

Medical History Questionnaire (in Spanish)
(138 KB)
 

Release of Information Permission
(31 KB)
 

Client Income Form
(40 KB)
 

Client Income Form (in Spanish)
(44 KB)
 
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