5150 E. Main St.  (Lower Level)

Columbus, OH 43213

Call Us Today!

(866)  515-2787

24-Hour Crisis Hotline

ASUR Counseling & Treatment Center

COUNSELING & TREATMENT CENTER

Carf Logo | Columbus, OH | ASUR Counseling & Treatment Center
  • HOME
  • SUPPORT SERVICES
  • REFERRAL/INTAKE
  • TEEN HOUSING
  • FORMS
  • JOIN OUR TEAM
  • CONTACT
  • GALLERY
  • DIP PROGRAM
  • ASUR Background Screening
FORMS
Carf Logo | Columbus, OH | ASUR Counseling & Treatment Center

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
  • HOME
  • SUPPORT SERVICES
  • REFERRAL/INTAKE
  • TEEN HOUSING
  • FORMS
  • JOIN OUR TEAM
  • CONTACT
  • GALLERY
  • DIP PROGRAM
  • ASUR Background Screening

5150 E Main St. (Lower Level), Columbus, OH 43213

(614)  604-8274

Fax Number: (614) 604-8276

info@asurcounseling.net

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