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Mood Treatment Center Logo Mood Treatment Center Logo Mood Treatment Center Logo
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Forms[email protected]2020-09-02T13:46:28-04:00

Emergencies

Our emergency line, (336) 525-9090, is staffed 24/7 for current clients.

Med Visit Form

Complete before your visit. Or use printable version.

Controlled Substance Agreement

Med Visit Form (Child)

To complete before medication visits.

Therapy Visit Form

To complete before medication visits.

Teletherapy Consent Form

Agreement to therapy/counseling through telehealth

Feedback and Comments

Let us know how we can improve our services.

Disability

Request disability or FMLA forms.

Legal services

For clients who need us to provide testimony or consultation for legal purposes.

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Release or records to other parties.

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