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Crossroads Services Inc

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Crossroads Services Inc.

Enrollment Packet Forms

Please complete the following forms prior to admittance into the Day Program at Crossroads Services, Inc. Once forms are completed, authorization may become official.

  • Bill of Rights for Individuals
  • Confidentiality Notice
  • Consent to Release of Information
  • Current Medication List 
  • Day Program Visitors Guide
  • Electronic Device Policy
  • Emergency Contact Information
  • Enrollment Agreement
  • Grievance Policy for Individuals
  • Individual Discharge Policy
  • Lifetime Medical History
  • Limited English Proficiency
  • Non-Discrimination in Services
  • Participant Dress Code
  • Participant Smoking Policy
  • Photo Release Form
  • Physical Form
  • Registration Form
  • Senior Intake Form
  • Snow Day Policy
  • Sunscreen Permission Form
Crossroads Services
Crossroads Services

814-515-1730

Crossroads Services

[email protected]

Crossroads Services

Mon – Fri: 7-45 AM - 3-45 PM

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