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

Monday 8 AM-6 PM

Tuesday 8 AM-7 PM

Wednesday 8 AM-8 PM

Thursday 8 AM-5 PM

Friday 8 AM-5 PM

Saturday 9 AM-3 PM

Sunday CLOSED

For an appointment call 304-728-3527

***Holiday Schedule will follow State and Federal Holiday Schedule.***

For closings or delays, please see our Facebook page - Jefferson Day Report Center

CHECK-IN

To expedite your check-in process, please sign-in by scanning the QR CODE below with your phone and entering the required information: