Patient Forms

Request for Services

If you would like to become a CrossPoint client or refer someone you know to become one, please complete the form below and we will get in touch with you. Thank you!

Child and Adolescent Needs and Strengths – CANS

Please complete the form below only if you have been instructed to by one of our staff members. This form is intended for clients who have already spoken to our intake team. Thank you!

Release of Information

This form authorizes CrossPoint Clinical Services (CPCS) to request and/or release protected health information (PHI) to or from a person or organization outside of CPCS.