Intake Packet

intake packet

Intake packet forms should be completed for the initial visit.  If you need assistance completing the forms, the intake worker will provide assistance at the initial appointment.  If you have questions about the forms, please call 810-667-0500 between 8:00 a.m. and 5:00 p.m.

Forms to Complete before your Appointment

Adult Personal Information Form (for people seeking services age 18 and over)

Adult Insurance Form (age 18 and over)

Child/Adolescent Information Form (for people seeking services age 0-17)

Child Insurance Information Form (age 0-17)