Step 1: Please save the required forms, prior to completing them. Download Adobe Reader X for free here.
1. Consent to Treatment (must be returned prior to appointment)
2. Intake Packet:
3. PCP Form (select the physical office location below):
Step 2: Please email the completed forms to: Plymouthstaff@refresh-mi.com
PATIENT FORMS FOR REVIEW: (no action required)
Outpatient Program Rules
Code of Ethics
Importance of Coordination of Care with PCP
Suicide and Crisis Hot Lines
SA Recipient Rights Brochure – Ann Arbor County
SA Recipient Rights Brochure – Genesee County
SA Recipient Rights Brochure – Macomb County
SA Recipient Rights Brochure – Oakland County
SA Recipient Right Brochure – Wayne County
Please note: These forms are in Portable Document Format (pdf) and require a pdf reader. If your computer does not have a pdf reader, you may download Adobe Reader X for free here.
Reader X download note: The download is preset to automatically include, for free, both the Google Chrome Internet Browser and the Google Toolbar for Internet Explorer. These are optional and are NOT required to view and/or print Heron Ridge Associates forms. If you do NOT want them included in your download, be sure to CLEAR the check box called “Yes, install Chrome as my default browser and Google Toolbar for Internet Explorer – optional.(32.11 MB)”.