Register for Services

Registration is simple.  If you are a prospective client begin your registration over the phone (parent or guardian may register a minor).  See our LOCATIONS page for hours of operation, phone and fax numbers.  Or, you may download a registration packet from the link below.  Or, call and request a registration packet to be mailed to your home address.

Submit registrations completed remotely to the desired clinic location via email scan, USPS mail or fax.  After the registration is processed, you will be given an appointment for a clinical intake.

Bring with you or send copies of the following items:

  • All current Insurance Cards – primary and secondary
  • Photo ID
  • Patient Social Security Card
  • Primary Medical Doctor’s name, address and phone number

If Patient is a minor, you will also need to bring in or send copies of:

  • Proof of custody ( Custody order)
  • Proof of address
  • Immunization record
  • Birth certificate

If you currently have no insurance, please bring in or send copies of the following for income verification:

  • 3 most current pay stubs  OR
  • Prior year tax return

Choose the packet that applies to your situation:

Print and fill out either the Adult or Child Information Packet, whichever applies to your situation. If you cannot print out the Information Packet, you can fill it out when you arrive for registration. But it is a great time saver if you can do it in advance.

Download/print Adult Information Packet

Download/print Child Information Packet

Notes:

Children are not required to attend the registration meeting.

Acceptance and schedule for intake is dependent on qualifying for services, and if required, obtaining authorizations for services.

Failure to provide all necessary documents can result in no scheduled clinical visits.

Please be advised that there is a Wait List for ALL private insurance. In order to be added to the list, the registration process must be completed.


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Our thoughts and prayers go out to the staff, clients and the loved ones of those lost at Arundel Lodge. ... See MoreSee Less

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This Thursday, the House of Representatives is scheduled to vote on H.J. Res 2, an amendment to the US Constitution that would require Congress to balance expenditures with revenues each year. If enacted, the "Balanced Budget" amendment (BBA) would likely force massive spending cuts to critical government programs, including mental health and addiction programs.

Will you take time today to urge your legislator to vote No on the Balanced Budget Amendment?

A Balanced Budget amendment would require Congress to approve a balanced budget every year. In the event of an economic downturn, safety net programs like Medicaid, Social Security, SNAP and more would be subject to steep cuts at the precise moment they are needed most.

Leading economists agree that when the economy is weakest, federal safety net programs should expand, not shrink, to cushion the economic blow to individuals and families and to keep the country from falling further into a recession.

Thursday's House vote is the first step toward enacting this harmful measure. By speaking up and voicing opposition to this measure, we can keep this bill from advancing to the Senate by sending legislators a short message today.

Urge your legislators to vote "NO" on H.J. Res 2!

Sincerely,

Chuck Ingoglia
Senior Vice President, Public Policy and Practice Improvement
National Council for Behavioral Health
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Offices will be closed today due to inclement weather. ... See MoreSee Less

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Employment Opportunities -
- Residential Program Manager for Dorchester County
- Residential Associates to work 7 days on 7 days off schedule (includes overnight/weekend)
- Residential Monitor to provide support during the overnight hours (this is not awake overnight - but requires sleeping at one of our residential locations in order to be available for health and safety issues that may arise overnight)
- Rehabilitation Associate - PT 24 hrs/wk in Cambridge

Contact hollidayr@ccinconline.com for more information or to send in your resume.
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