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African American Mother with Daughter
Family Having Fun

 Services We Provide

Individual Therapy
Family Therapy
Group Therapy
DUI Education
Diagnostic Assessments / Clinical Comprehensive
Substance Abuse Treatment
Re-entry assistance for returning citizens
Medication Management
Psychiatric Rehabilitation Services (PRP)

Patient Forms and Registration

Patient Forms

Welcome to our center and thank you for choosing Changing Lives Adult & Youth Services as your mental health provider. Before your appointment, please complete all patient forms from the links below.

* Note: By taking some time prior to your appointment to fill out the required forms online, you can help reduce your office wait time.

Plan on arriving 20 minutes prior to your appointment and bring the following:

  • Insurance card
  • ID
  • List of any medications you are currently taking


1) Consent For Treatment

2) Program Participants Rights And Responsibilities

3) Notice Of Privacy Practices

4) Patient Health Questionaire

5) Release For Medical Treatment

6) Emergency Form

7) No Shows and Cancellations


Signature Pages

OMHC/IOP Signature Page


Schedule Appointment

Start your new path in life and be the change today!