Cumberland River Behavioral Health
Client Forms and Portal Access
Cumberland River Behavioral Health
Client Portal Access
Cumberland River Behavioral Health
Client Forms
Client forms are available below for download in both English and Spanish versions.
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Client Rights / Responsibilities
English: Click Here
Spanish: Click Here
Admission Form
English: Click Here
Spanish: Click Here
Confidentially of Substance Abuse Records
English: Click Here
Spanish: Click Here
Free Language Assistance Form
Spanish: Click Here
Health Screening
English: Click Here
Spanish: Click Here
Notice of Privacy Practices
English: Click Here
Spanish: Click Here
Telehealth Consent
English: Click Here
Spanish: Click Here
Financial Information Form
English: Click Here
General Consent and Acknowledgement
English: Click Here
Spanish: Click Here
Grievance Procedures for Clients
English: Click Here
Spanish: Click Here
HIPAA Confidentiality
English: Click Here
Spanish: Click Here
No Show Policy
English: Click Here
Spanish: Click Here
Release of Information
English: Click Here
Spanish: Click Here
Service Fee Agreement
English: Click Here
Spanish: Click Here
Sliding Fee Scale Posting 2025
English: Click Here
Spanish: Click Here