Behavioral Health

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 Mental Health and Alcohol & Drug

 

The Amador County Behavioral Health Department supports the overall health and well-being of clients with serious mental illness, emotional disturbances, and substance use disorders.  The department is dedicated to quality and effective treatment.

 

 Behavioral Health Intakes  

On Line Forms Available

Intake appointments require the forms below be completed before an appointment can be made. These forms are available to download and print.

Notice of Privacy Practices - Review for your records

All five forms must be completed.

1. Authorization for Use & Disclosure of PHI

2. Behavioral Health Consent-Release for Services

3. Screening Form

4. Health and Self Identification Form 

5. Client Information Form

For additional resources in Amador County see Amador County Resource Sheet

 

The Problem Resolution Form can be used to express a concern or grievance regarding services received or to appeal a denial or change of services.

Problem Resolution Form

Problem Resolution Form (LARGE PRINT)

Formulario De Resolucion De Problemas

CONTACT INFORMATION
Address: 10877 Conductor Blvd. Suite #300 Sutter Creek CA 95685
Office Phone:         (209) 223-6412
24 Hour Toll Free #: (888) 310-6555
Fax #: (209) 223-0920
Business Hours: Monday - Friday 8:00 am - 5:00 pm