5150 E Main St. 104, Columbus, OH 43213

1528 Brice Rd, Reynoldsburg, OH 43068

Call Us Today!

(614) 604-8274

24-Hour Crisis Hotline

ASUR Counseling & Treatment Center

COUNSELING & TREATMENT CENTER

FORMS

asur patient forms

Download and Complete Before Your First Visit

ASUR Counseling 07-004-01 Patient Code Of Conduct ASUR Counseling 07-005-01 Patient Confidentiality Agreement ASUR Counseling 42 CFR Part 2 ROI Form Criminal Justice ASUR Counseling Patient Financial Responsibility Agreement ASUR Counseing Treatment Consent 3-7-19 ASUR Patient Admission Form

ASUR Youth Services Location:

5150 E Main St. 104, Columbus, OH 43213

ASUR Adult Services Location:

1528 Brice Rd, Reynoldsburg, OH 43068

Fax Number: (614) 604-8276

info@asurcounseling.net

Mon - Fri: 9:00 am - 6:00 pm
Sat - Sun: Appointment Only

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