Forms – Adult

This image has an empty alt attribute; its file name is image-1.png

ONLINE FILLABLE FORMS FOR ADULTS

Please submit a copy of identification, insurance card (if unable to upload in the form), and any relevant mental health, medical, or educational records to support care to one of the following:

  1. Email Forms@orchardhumanservices.org
  2. Secure Fax (877) 660-8884
  3. Text 770-686-0894

ADDITIONAL SPECIAL FORMS

IF YOU ARE GUARDIAN OF AN ADULT OR AN ADULT WHO IS AUTHORIZING ANOTHER PERSON(S) TO BE INVOLVED IN YOUR CARE:

Adult Authorization Form

SAFETY PLAN

Click Here To Access Safety Planning Form

Crisis Support Resources

State Crisis Resources:

  • Florida Mental Health Hotline at 866-903-3787
  • Georgia Crisis & Access Line 1-800-715-4225
  • Virginia Mental Health Hotline at 866-903-3787

National Crisis Resources:

  • National Crisis Support Text “HELLO” to 741741
  • National Crisis Hotline 1-800-273-8255
  • Call 988 (National Suicide Crisis Line)
  • Call 911 (Call for Emergency Response) 
  • Go To Local Emergency Room

Orchard’s Crisis Resources:

  • Download “Self-Care Guide” from Orchard’s website:

https://orchardhumanservices.org/wp-content/uploads/2019/04/Self-Care-Guide.pdf

  • Contact Orchard Human Services – we offer limited crisis support services:

Text or call (770) 686-0894 [Must Call If After Hours; We Do Not Monitor Texts After Hours]

Fees are discussed on the counseling page; or ask staff for more information.

Comments are closed.