Welcome to the intake paperwork to get you started with classes
Please fill out all the paperwork and email back to sregan@nullrangeviewcounselingcenter.com
If you need Level II 4 Plus program please fill out number 10 as well
- Interstate-Compact-Client-Questionnaire
- Consent to Treat
- Release of Information
- Michigan Alcoholism Screening Test (MAST)
- Drug Use Questionnaire (DAST)
- Addiction Severity Index
- Staff Disclosure
- Affidavit of Enrollment (DR2643)
- Infectious Disease Questionnaire
- Level II 4 plus TX. Paperwork – –