Enrollment Prescreening

Are you interested in perinatal or parenting services? *

Yes
No

NOTE: Our group services are currently available to parents starting in pregnancy and through age 6. Would you like to continue signing up for perinatal or parenting group services?” *

Yes
No

Are you requesting services for someone over the age of 18? *

Yes
No

What type of services are you seeking? *

Mental health
Drug and alcohol recovery
Medication Assisted Treatment (MAT)

NOTE: CFD only offers psychiatry for clients who are active with a CFD therapist. A therapist will work with you to see if a referral to CFD psychiatric services is appropriate. Would you like to continue signing up for therapy? *

Yes
No

NOTE: Medication Assisted Treatment (MAT) is for opioid and/or alcohol use concerns. Would you like to continue signing up? *

Yes
No

What is your insurance type?

Insurance type MH *

Oregon Health Plan (as primary or secondary coverage)
Commercial insurance only
None