Opening Paperwork


In response to the COVID-19 outbreak, and in an effort to ensure the health and safety of our community, new clients may be asked to complete a virtual intake assessment.  For more information, please call 503-325-5722.

Clatsop Behavioral Healthcare

New Clients: Please review the following documents:

Adult Mental Health Application Packet

Alcohol & Drug Application Packet (Ages 14+)

Child Mental Health Application Packet

North Coast Pain Clinic Application Packet

Additional Documents:

Complaint and Resolution Form

Declaration of Mental Health Treatment

Notice of Privacy Practices

Orientation Packet

Release-of-Information Generic

Release-of-Information for Primary Care Provider

Voter Registration

En Español:

Paquete de Admisión Ambulatoria en Español

CBH Paquete de Orientacion del Cliente

Guía para la Declaración para el Tratamiento de la Salud Mental en Oregon

Aviso de Practica de Privacidad

Tarjeta de Inscripción de Elector de Oregon

North Coast Crisis Respite Center

Admissions by referral only.  Completion of a referral packet does not guarantee placement.  For questions regarding admissions, please call the NCCRC Program Manager at  971-704-4018.  

Referral Packet

North Coast Wellness Center

Intake Packet

Outpatient Alcohol and Drug Program

Outpatient Alcohol & Drug Intake Packet (Ages 14+)

Outpatient Alcohol & Drug Intake Packet (Parental Consent Version)

Mandated Program

Mandated Intake Packet (Ages 14+)

Mandated Intake Packet (Parental Consent Version)