ADULT INTAKE PAPERWORK

Application & Consent
for Services (Adult)
Patient’s Rights & Responsibilities
Release of Information
Notice of Privacy Practices
Medical Screening

Lakes Region Mental Health Center provides comprehensive, integrated mental health treatment for people living with – and recovering from – mental illness and/or emotional distress.

info@lrmhc.org

General: 603-524-1100 Emergency: 833-710-6477

© (2022) Lakes Region Mental Health Center..