Now accepting Telehealth appointments. Schedule a virtual visit.

Forms & Applications


Please select a link below to process one of our applications: 

pdf Cars Jail Assessment~Request Form

pdf Cars Employment Application

pdf HIPAA Patient Privacy Notice


Updated Referral Application:

pdf Residential Addiction Recovery Center - Application Packet

Please go to the FAQ page to see what items should or should not be brought to the Residential Addiction Recovery Center(

What You Have To Do Differently

  • You are not required, in most cases, to go through the time-consuming process of DSS approval any longer. We hope this will allow us to say "Yes" much quicker in the future.
  • Complete and submit the new referral application in order to determine clinical approval and who the payer is (
  • Complete the LOCADTR 3.0 in the Health Commerce System
  • (
  • Obtain and submit a Court Mandate letter for clients who are mandated to treatment
  • Depending on the payer, we may ask you to obtain a pre-authorization number


Self Assessment Tools:

pdf CAGE-AID Self-Administered Drug/Alcohol Screening

If you have any questions or concerns after you have completed the questionnaire, or you would like to set up an appointment for an evaluation, please call 607-273-5500 to speak to our admissions coordinator. 

Our Locations

Choose your preferred location