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Client Rights Annual Update Form

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Client Rights Annual Handout

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Patient Information Form

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New Client Service Orientation

English


Authorization for Treatment

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MH/SA Treatment Agreement (OP Treatment Agreement)

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Financial Agreement

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Service Fee & Sliding Scale

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Notice of Privacy Practices

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No Income/Cash Only Verification

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Financial Intake Letter

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ROI - MCO/CCNC/My Health Insurance

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ROI - NCTOPPS/GPRA

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ROI - Primary Care Provider

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ROI - Emergency Contact

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ROI - U.S. Federal Probation/Probation Officer

English

ROI - County Probation

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ROI - Legal Guardian

English: Parent/Guardian | English: Foster Parents | English: Guardian Ad Litem

Spanish: Parent/Guardian | Spanish: Foster Parents

ROI - Schools

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ROI - Department of Social Services

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ROI - MAKO Medical

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ROI - Medicaid Transportation

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ROI - Nursing Home / Assisted Living / Group Home

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ROI - Family Friends

English | Spanish

ROI - Attorney

English

ROI - Blank Form

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