DHHR Forms

You must complete all forms included in this section. Please contact the office at (304) 728-3527 if you need assistance.

Intake: https://jeffersondrc.wufoo.com/forms/mffbwtl1kioyfj/

HIPAA Authorization: https://jeffersondrc.wufoo.com/forms/m1coei030qn1fb2/

Client Handbook: https://jeffersondrc.wufoo.com/forms/r6uxjbz07qb71m/

Behavioral Health Screen: https://www.surveymonkey.com/r...

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GET IN TOUCH

CONTACT US REGARDING MORE INFORMATION ABOUT SERVICES WHICH WE PROVIDE.

Location

Availability

Evening hours and Saturday's by appointment only!

Call (304) 728-3527 for the most updated schedule

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