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Forms

Intake – Child/Adolescent
Intake – Adult
Psychological/Parenting Capacity Evaluation – Adult
Consent for Release of Information
Financial Agreement & Consent for Treatment
Notice of Privacy Practices
Referral – Adult
Referral – Child/Adolescent

Formularios

Admisión de Niños y Adolescentes
Admisión de Adultos
Autorización Para Divulgar/Intercambiar Información
Acuerdo Financiero y Consentimiento para Tratamiento
Aviso de Prácticas de Privacidad/Confidencialidad

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Hours

Monday – Friday 8am-5pm
Evenings by appointment only.
Address/Phone

Crossroads Counseling Center
255 18th Street SE
Hickory, NC 28602
(828)327-6633
(828)327-3385 fax

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