Become a Client

Individuals who are seeking services should look at the sections below and fill out the forms for the program(s) they are interested in. The forms include a large amount of information, some of which may not apply to you. Please answer all applicable questions as thoroughly as possible. Please complete all forms that are under the heading of the service you are interested in. Not completing all forms may delay your request for services.

There is the possibility that due to the nature of some of the questions, a person could have difficulty responding to particular sections. If this occurs, simply fill in as much information as you are comfortable, and you can discuss this more with your intake clinician. If you are actively suicidal, do not complete the paperwork. Seek emergency medical services by calling 911.

Download your forms using the links below.

If you have issues or questions, please email for assistance.

In order to fill the forms electronically, you must have a version of Adobe Acrobat installed on your computer. Download Acrobat for free here.

You will also need to create a new Digital ID in order to electronically sign the forms. Please follow instructions in Adobe.

Client Forms

Forms for Counseling and/or Clinical Case Management Services

Application for Counseling and/or Clinical Case Management
Intake Assessment + PHQ-9 + GAD7
Cancellation/No-Show Policy

Form for Sexual Health in Recovery Group

SHiR Educational Group Registration

Forms for Housing Services Only

STRMU Eligibility Packet
ESG Forms
STRMU Renewal Packet
TBRA Eligibility Packet
TBRA Landlord Packet

Intensive Outpatient Program

IOP Orientation Packet
Family Support Group Registration Form

Client Resources

Client Fee Scale & Payment

Fee Scale
Payment Form

Client Surveys

Client Satisfaction Survey (Online) – English
Encuesta de satisfacción del cliente (en linea) – Español
Client Satisfaction Survey
Ryan White Services Survey

Client Complaint Process

Client Compliant Process