Patient Enrollment

Our associates are highly qualified and experienced, and are passionate about the care they provide. Not only will our providers treat your existing conditions, we will also help to create a custom recovery plan that's right for you. We strive to help you improve your quality of life.

Please begin with the Capeside Addiction Care Patient Intake & Medical History form. Complete and submit all forms. A Patient Representative will contact you to complete the enrollment process.

*All forms are made and processed through Updox. Your information is secure, and will only be used for the purpose of building your patient file with Capeside. View Updox's Privacy Policy here.

Enrollment Forms

1. Intake & Medical History

2. Consent for Medical Records Release

3. HIPAA Privacy Authorization

4. Financial Policy

5. Drug Screening Policy

6. Subutex Policy

7. Acknowledgment of Policies

8. Accountability Partner Consent

9. Relapse Prevention Plan

10. SMS Messages Consent

11. Authorization to Release Healthcare Information

12. Patient Health Questionnaire

13. Mood Disorder Questionnaire

14. Generalized Anxiety Disorder Test

15. Drug Abuse Screening Test