Address

  • 750 South Abbe Road
    Elyria, Ohio 44035

Office Forms

HIPPA notice of Privacy Practices
HIPPA notice of Privacy Practices Acknowledgement Form

Mental Health Services Forms

If you are seeking mental health services please click below on the three intake forms. Printing out and completing the forms will allow you to save much time at your first visit. Please print all the forms and complete/sign them where indicated. Bring the forms to your first session and turn them into the secretary.

Client Intake Form
Scheduling and Financial Policies
Financial Agreement
Office Policies and Procedures
Adolescent Initial Evaluation Form
Minors in Mental Health Therapy
Adult Initial Evaluation Form

Chemical Dependency Services Forms

If you are seeking chemical dependency services please click below on the five intake forms. Printing out and completing the forms will allow you to save much time at your first visit. Please print all the forms and complete/sign them where indicated. Bring the forms to your first session and turn them into the secretary.

Client Info and Policy Statement
CD Consent to Treat
Client Intake Form
Financial Agreement
Scheduling and Financial Policies
Office Policies and Procedures

✕

As we continue to cope with the challenges posed by the COVID-19 pandemic Psych and Psych Services is open for business and accepting new clients. Whether you are new to Psych and Psych Services, or an existing client, call us at 440-323-5121 to set up an appointment with one of our therapists. Many of our therapists are now offering face-to-face sessions (use of a mask is required by our therapists and strongly encouraged by our clients).  Please ask the receptionist if the therapist you wish to see is currently offering face-to-face sessions.  All therapists are also offering counseling services by telephone and some offer video sessions via “Zoom”. Please ask the receptionist for details if you are wanting to obtain an assessment for placement in one of our Chemical Dependency Program groups.