Welcome to our Intake Paperwork Link
IT IS CRITICAL THAT WE RECEIVE YOUR PAPERWORK PRIOR TO YOUR FIRST APPOINTMENT TO AVOID ANY DELAY OF SERVICES.
To access the Intake Paperwork please click on the HCBH PDF Intake Packet link below.
PLEASE NOTE: When you are completing the intake paperwork if you have any questions or concerns about what you are to fill out or sign, please contact your local HCBH office at the number listed below.
If you are obtaining services for a Substance Abuse Evaluation you must bring a copy of your ten (10) year driving record to your initial session with a HCBH clinician. You can visit the WYDOT office in person to get a copy of they can mail this form to them with their $5.00 fee (requires 7-10 business days). You may also download this form below. The form has a place for the you to indicate to fax or mail it directly to the appropriate HCBH office.
Afton:
(307)885-9883
Fax: (307) 885-5206
Kemmerer:
(307) 877-4466
Fax: (307) 877-9832
Pinedale:
(307) 367-2111
Fax: (307) 367-2166
Evanston:
(307) 789-4224
Fax: (307) 789-4225
