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Complete Intake Online

Required Treatment Agreement

Outpatient Services Intake Packet

Outpatient Services Intake Packet

Modified Intake Packet

Outpatient Services Intake Packet

Outpatient Services Intake Packet

Outpatient Services Intake Packet

The complete Intake Packet complete packet 1 and packet 2

Controlled Substance Agreement

Outpatient Services Intake Packet

Consent to Release and Exchange Information

Suboxone/Buprenorphine Patient Form

Consent to Release and Exchange Information

Consent to Release and Exchange Information

Consent to Release and Exchange Information

Permission to Communicate with Others Regarding Your Care

DWI Intake Packet

Consent to Release and Exchange Information

Residential Recovery Supports Intake Packet

Complete Intake Packet for ADETS, Short Term Treatment, Long Term Treatment, IOP or Residential Treatment

Residential Recovery Supports Intake Packet

Consent to Release and Exchange Information

Residential Recovery Supports Intake Packet

Complete SHYAS CARES Intake Packet for  Residential Recovery Supports Program Phase 1 and Phase 2

Download Intake forms

SHYAS 2023 Intake (pdf)

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Required Treatment Agreement (pdf)

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Controlled Substance Agreement (pdf)

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Consent to Release and Exchange Info (pdf)

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New Patient Questionnaire (pdf)

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Patient Follow Up Form (pdf)

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