24-Hour Crisis Line: (503) 325-5724

Clients may choose to complete and submit paperwork online. To do so, click on the link(s) below. 

For more information, please call 503-325-5722.

Mental Health Services

Adult Mental Health Enrollment Packet

Youth Mental Health Enrollment Packet
North Coast Pain Clinic Enrollment Packet

Servicios de salud mental

Mental Health Enrollment Packet

Paquete de Admisión Ambulatoria en Español

Alcohol & Drug Services

Alcohol & Drug Enrollment Packet 
(Ages 14+) Alcohol & Drug Enrollment Packet 
(Parental/Guardian Consent)

Servicios de alcohol y drogas

Mandated Treatment Services

Mandated Treatment Enrollment Packet 
(Ages 14+) Mandated Treatment Enrollment Packet 
(Parental/Guardian Consent)

Servicios de tratamiento obligatorios

Referral Forms

Outpatient Services Referral Form Medication Assisted Treatment (MAT) Referral Psychiatric Consult Only Referral Form Residential Referral - North Coast Crisis Respite Center Respite Referral - North Coast Crisis Respite Center

Formularios de referencia

Release of Information

Release of Information Form (Generic) Release of Information for Primary Care Provider

Liberación de información

Information & Notices

Complaint and Resolution Form Declaration of Mental Health Treatment Notice of Privacy Practices Orientation Packet Voter Registration

Información y avisos

Guía para la Declaración para el Tratamiento 
de la Salud Mental en Oregon Aviso de Practica de Privacidad Paquete de orientación Tarjeta de Inscripción de Elector de Oregon

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