Adolescent Intake Forms

Please fill out the attached forms that apply to you and download them to your device. Once finished you may send them to info@gsccohio.com or call our main office at 330-499-3065 if you need assistance.

Adolescent Consent 2022
File Size:	108 kb
File Type:	pdf

Download File

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Adolescent History 2022
File Size:	251 kb
File Type:	pdf

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Policies and Procedures
File Size:	546 kb
File Type:	pdf

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Health Insurance 2022
File Size:	524 kb
File Type:	pdf

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Release of Information 2022
File Size:	155 kb
File Type:	pdf

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Self Pay 2022
File Size:	213 kb
File Type:	pdf

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Teen Checklist 2022
File Size:	411 kb
File Type:	pdf

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Telehealth Consent 2022
File Size:	202 kb
File Type:	pdf

Download File

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Late Cancel Payment
File Size:	136 kb
File Type:	pdf

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