Forms

For convenience, the iTrust Wellness Group has uploaded several of its most utilized forms to the website. The documents are available for reference and download below. Please note, policies and procedures are subject to change. All clients are required to agree to the office policies and procedures, indicating understanding and express consent prior to receive treatment.

(Please click the PDF image below to download form)

iTrust Referral Form

HIPAA Data Use Agreement

Policies and Procedures

Consent to Release Information

Suboxone Treatment Guide

SBIRT Substance Abuse Resources

Office Financial and Payment Policies

Autumn Leaves Referral Form

Opioid Analgesic REMS Patient Counseling Guide

Therapy/Psychiatric Resource List (Greenville and Surrounding Area)