Please note this HIPAA compliant form allows you to share information with us about the person you are referring to Oaklawn. It is a one-way communication tool.
We will use this information to inform our assessment and treatment if the client comes to us for services.
We will not reach out to clients to ask them to come in for an assessment, please share our Open Access Clinic Information with them. If you would like rack cards or fliers about Open Access for your organization, please fill out this form, https://hipaa.jotform.com/221033888759063, or email email@example.com
Please review our Services page https://oaklawn.org/our-services/ to ensure the service you’re referring to is one we offer. If you have questions about our services, please contact our Access Center at firstname.lastname@example.org