Enrollment Prescreening

Are either you or the person you are requesting services 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: 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

CFD can only accept OHP through our Centralized Assessment process at this time. CFD offers services by sliding scale with intern therapists. Would you like to sign up for the sliding scale program? *

Yes
No