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Therapy
Independent Medical Evaluations
Alcohol and Drug Treatment
E.M.D.R.
Crisis Intervention
Intensive Outpatient
Community Support Groups:
Service Details:
Main office:
58 Timber Creek Drive
Cordova, TN 38018
Phone1: 1-901-566-1002
Phone2:
Fax:
Customer Support:
Phone: 1-800-
Below are the necessary forms that need to be filled out before evaluation or treatment can begin.
Please click each form name and print at you convenience. The forms are in an Adobe pdf. format to assure consistency. You will need an Adobe Acrobat Reader in order to view the forms. If you do not have Adobe Acrobat Reader you can download a free reader by clicking here.
Authorization for Evaluatiuon and Treatment of Minors and Adult Dependants.pdf
Consent for Evaluatiuon and Treatment.pdf
Financial Agreement.pdf
Information Release.pdf
Insurance Authorization.pdf
Medication Requests.pdf
Patient Regsitration.pdf
PrivacyPolicy.pdf
Policies and Procedures.pdf
Verification of Notice of Privacy Policy.pdf