Emergency crisis response is available 24/7/365. Call 1-866-495-3651
1-866-495-3651
Signed in as:
filler@godaddy.com
Sign out
Account
Modified Intake Packet
The complete Intake Packet
Suboxone/Buprenorphine Patient Form
Permission to Communicate with Others Regarding Your Care
Complete Intake Packet for ADETS, Short Term Treatment, Long Term Treatment, IOP or Residential Treatment
Complete Intake Packet for Long Term Residential Treatment
SHYAS 2021 Intake online (pdf)
Required Treatment Agreement (pdf)
Controlled Substance Agreement (pdf)
Consent to Release and Exchange Info (pdf)
New Patient Questionnaire (pdf)
Patient Follow Up Form (pdf)
Copyright © 2007 S&H Youth and Adult Services, Inc. - All Rights Reserved.