New Counseling Client Forms

While it is not required we do encourage you to download, print off and complete this PDF which contains the paperwork we will need prior to you receiving services at Chrysalis Institute.  If you are unsure how to complete parts of the form just leave those sections blank and we will complete them together in person at your first appointment.

Download New Counseling Client Form

If you have any trouble with the above link call us at 405-912-5145 or email info@ciokc.com.

 

Client Referrals From Other Agencies

Referring Agency,

Thank you for considering us for your behavioral health service referrals.  Please note we are a CARF accredited professional behavioral healthcare provider. We have been doing business in Moore for over nine years now. We employ the most highly trained, people friendly helping professionals available. Rest assured your patients will receive professional services delivered with compassion and respect.  Be sure to let us know if you want us to update you on anything about the person i.e. if the showed up etc. Please download our referral form from the following link complete it and fax or email it to use at 405-912-5147. If you have any questions please call us at 405-912-5145 or email us info@ciokc.com.

New Patient Referral Form