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Alpha Center Registration Forms

In an effort to streamline the registration process, you can download the necessary forms, prior to your visit with us here at the Alpha Center.

 

Please sign ALL four (4) forms and bring to your next visit:

HIPAA POLICY

UPDATED ENROLLMENT APPLICATION FORM

PHYSICAL EXAMINATION FORM

ALPHA CENTER CLIENT'S RIGHTS

You will need Adobe Reader in order to view our forms.  Most computers already have this installed, but if you do need it, you can download  for free and install it from here:

© 2016 Alpha Center

Alpha Center is a tax-exempt 501(C)(3) nonprofit organization. Your gift is tax-deductible as allowed by law.

CALL US

TODAY

TO PLAN A VISIT

(765) 286-2800

CALL US

TODAY

(765) 286-2800