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"Discover the best version of you"
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  • Who We Are
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  • More
    • Home
    • Who We Are
    • Clinical Services
    • Meet The Director
    • Shine Staff
    • Insurance & Billing
    • Client Forms
    • ESA Certification

Call Now: 586-281-6815

  • Home
  • Who We Are
  • Clinical Services
  • Meet The Director
  • Shine Staff
  • Insurance & Billing
  • Client Forms
  • ESA Certification

Client forms

Agency documents are now available online and can be downloaded, saved and printed.  

Full Intake Packet- Children (Patients of K.Hazel/S.Evans) (pdf)Download
2024 Revised Full Intake Packet-Teens & Adults (pdf)Download
Revised 2024 Card On File (pdf)Download
Revised 2024 Consent for Treatment (pdf)Download
Revised 2024 HIPPA (pdf)Download
Revised 2024 Release of Information (pdf)Download
Revised 2024 SWC Reimbursment Rates (pdf)Download

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  • ESA Certification

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