I understand that the Drug, Alcohol, and Mental Health Services are provided by independently licensed counselors, substance abuse counselors, and counselor trainees under supervision and that the independently licensed counselor will review treatment plans and sign appropriate forms for payment. The agency offers no guarantees or positive assurances regarding the outcomes of the therapeutic services.
: Agency staff strongly believe that the benefits of Mcntal Health and/or Substance Abuse Treatment greatly ourweigh the risks. We want you to be aware of both in order to make the best decision for you as a client.

Risks of treatment could include but are not limited to the following: decrease in income, time away from your family, and old traumas resurfacing

Benefits of treatment could include but are not limited to the following: Improving your level of functioning, improving mental health, abstinence from all substances, ability to successfully function in society without illegal activities and improved family relationships.

We encourage you to discuss both the risks and benefits with any of our staff members at any time during your treatment.

No person is excluded from participation in the services of our program on the grounds of race, color, or national origin in accordance with Title VI of the civil Rights Act

I understand that I have the right to discuss my concerns, complaints, or grievances with any staff member from the agency who is involved in my care. I also have the right to file a grievance with the agency by contacting any staff member of the agency, Client Advocate, Kevina Matthews or the Ohio Department of Mental Health.