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Walk-In: Mon - Fri 8:30am - 5pm
Call Us: 772-569-9788
PACC: Mon, Wed, Fri 8:30am - 5pm ~ Tues, Thurs 10am - 6:30pm
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A 501(c)3 NONPROFIT (EIN#59-1693337) | AN AFFILIATE OF MENTAL HEALTH AMERICA
A UNITED WAY AGENCY OF EXCELLENCE
Mental Health Association
Patient Forms
These forms to be completed for scheduled appointments only. Walk-In screenings must complete paper work in person. If applicable, please choose the relevant form, print from your browser, and fill it out so that you can bring it in with you.
Having trouble? Give us a call - 772.569.9788
Available Patient Forms
New Adult Intake Form
New Child/Teen
Intake Form
Phsycho-Educational Class Registration Form
(Adult)
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