admissions and referrals / applyadmissions and referrals / apply

Our wonderful team is experienced in collecting the necessary information required for a successful admission. We make the process as easy as possible for you and the people you care about.

If you are a family member or individual seeking treatment, please contact Rachael McLaughlin, MS, LPCC-S, NCC at 440-426-2009. The forms below will be used for the admissions process.

If you are a referring individual or organization, please contact Rachael McLaughlin, MS, LPCC-S, NCC at 440-426-2009. We require an authorization for release of information form (available below) to begin the admissions process.

Download all admission forms in one zip file

This single download contains all the individual forms listed below

Download Zip

Individual PDF Forms

Release Authorization

Begins the process of gathering information

Download PDF

Psychiatrist Referral Form

Provides important medical history

Download PDF

Family and Personal History Form

Provides critical background information

Download PDF

Annual Physical Form

To be completed prior to intake and updated annually

Download PDF

Financial Application

To be completed for financial aid requests

Download PDF

SNAPS Questionnaire

Survey of your Strengths, Needs, Abilities, and Preferences

Download PDF

To provide an opportunity for adults with serious mental illness to experience a self-reliant and satisfying life through participation in a vibrant residential therapeutic community