SUBSTANCE USE TREATMENT AVAILABLE TODAY! 203-245-0412

Waterstone Forms

After selecting the appropriate forms, please print and fill out forms PRIOR to your scheduled appointment. Thank You!

Release of Information Form

Form

Consent to Treatment & Assignment of Benefits

Form

Treatment Contract

Form

Notice of Privacy Practices

Form

MAT Attendance Agreement

Form

Financial Agreement

Form

Client Substance Use Questionnaire

Form

Telehealth Agreement/Consent

Form


Servicing Southern, Central & Coastal regions of Connecticut.