Forms & Downloads
Forms & Downloads
Our goal is to ensure that everyone has easy access to the resources they need, whether you are taking the first courageous step toward healing, recovery, and lasting wellness, or you are helping someone else do the same.
For Patients and Families: Here you’ll find forms and downloads to help you prepare for your care and connect with services at both Sojourner Recovery Services and the Transitional Living Center (TLC).
For Referral Partners: Your collaboration helps individuals access timely, effective care across behavioral health and recovery support. Together, we can make the path to wellness clearer and more accessible.
If you have any questions along the way, don’t hesitate to contact us!
Downloadable Forms
Referral Partners
Health Assessment Questionnaire
To provide a snapshot of the individual’s current needs.
Referral Form
To guide a smooth and timely intake process.
Transitional Living (TLC) Patients
Consent Agreement Form
Consent to Receive Treatment and Support Services
Medical Records Photo Consent
Medical Records Photo Consent
PHI Disclosure Agreement
Notice of Privacy Practices Client Consent to Use or Disclose Personal Health Information
Patient Financial Agreement
Patient Financial Agreement
Standard Authorization Form
Standard Authorization Form
Telehealth Consent Form
Telehealth Consent Form
Health Assessment Questionnaire
Health Assessment Questionnaire
(No need to print – it’s provided for you on site)
Sojourner Recovery Services Patients
Consent Agreement Form
Consent to Receive Treatment and Support Services
Client Demographics Form
Client Demographics Form
Health Assessment Questionnaire
Health Assessment Questionnaire
(No need to print – it’s provided for you on site)
PHI Disclosure Agreement
Notice of Privacy Practices Client Consent to Use or Disclose Personal Health Information
Patient Financial Agreement
Patient Financial Agreement
Telehealth Consent Form
Telehealth Consent Form
Standard Authorization Form
Standard Authorization Form
Registration Form
Registration Form
South Oaks Gambling Screen
South Oaks Gambling Screen (SOGS)