Forms

Welcome new clients. Thank you for choosing TriCare Counseling & Consulting, Inc. to work with you and or your family.

Blank Referral Service Order form  – for physician offices to complete and fax to 866-279-1991

Registration Package: This packet must be completed by the client or legal guardian. Please bring to office with your ID and insurance card to the appointment. 

Agreementforsuboxonereferrals  – If you were referred from a Suboxone program please review this form, sign and bring to your intake session with the Consent Package. 

Card Payment Consent Form  -Complete this form if you wish for us to keep a card on file for your future appointments.

If you have any questions feel free to call us at 910-249-4219