Webcam

Search

   
 
Home Government Departments Agencies Municipalities Area Info Alerts
 

Community Services

"Serving the Residents of Delaware County..."


   

Up
About Us
Services
Referral
Location & Schedule
Client Rights
SPOA
HIPAA
Fees
FAQs
Contact Us
Links

 

Mental Health Clinic
Referral

     
 

MAKE A REFERRAL/APPOINTMENT

Many individuals are referred to our Clinic by Physicians, Schools, Social Services, Probation, family members or friends. Self-referrals are also accepted.

The Clinic is open Monday through Friday, 9:00 am to 5:00 pm with limited evening hours available. You can call the Adult Clinic at 607-832-5888 and the Family and Children’s Services at 607-832-5889 to make a referral/appointment.

The clinic accepts most insurance, Medicare and Medicaid. There is a sliding fee schedule for those without insurance coverage.

 

   

We recognize that your time is valuable.
We understand that our intake paperwork can take some time to fill out.
Feel free to print  these documents and complete before arrival for a quicker intake process.

Thank you.

FORMS

Children and Families

Child Client Information (pdf)

Parent Child Questionnaire (pdf)

Adolescent Questionnaire (pdf)

Medical Assessment Form (pdf)


Adult Mental Health

Adult Client Information (pdf)

Adult Questionnaire (pdf)

Medical Assessment Form (pdf)

 

 

   
   
 

 
     
 

Website maintained by Delaware County Information Technology Services