Pre-Admission Forms

PAPERWORK NEEDED PRIOR TO ADMISSION
TO THE CENTER FOR PSYCHIATRIC RESIDENTIAL SERVICES

In order to meet all guidelines from our governing agencies, we need patient information prior to admission to any program at CPRS.

Once a youth has been accepted into the program, the following forms will need to be completed before the actual admissions date.

The following forms are in Microsoft Word format.

Pre-Admission Checklist

Informational Program Policies &Procedures (Return page 5 only)

Vital Statistics pg.1

Vital Statistics pg. 2

Youth Health Assesment

Additional Medical Information

Medical Treatment Authorization

Placement History

Legal Information

Behavior List

Release/Exchange of Confidential Information between East Kentwood High School, Home School & the Center for Psychiatric Residential Services

Kentwood Pub-prev school info

Billing And Agency Info

Center for Psychiatric Residential Services Contract

Clothing Inventory