Community Members Wellness Center Registration
Please complete the following form in order to be verified and granted access to OCHN's Wellness Center. All information provided in this form is confidential and used only for OCHN Wellness Center registration purposes.
Guardian or Support Staff
Check the box if you are a guardian or support staff professional who will be accompanying community member.
Please provide your public mental health ID (CON ID) to verify that you are receiving services through OCHN's network.
Type "NA" if you are a guardian or support professional.
Is a direct care professional accompanying you during your visit to OCHN's Wellness Center?
If yes, they must also complete the registration process.
Select your provider from the drop down list.
Community Living Services of Oakland County Community Network Services
Oakland Family Services
Training and Treatment Innovations
Type your current provider below if they are not listed in the selection above.
Waiver + Rules and Regulations
Download the waiver and read the rules and regulations by clicking the following link:
By checking box below, you certify you have read and understand the rules and regulations document.
Upload a signed copy of the waiver here. If you are unable to upload the waiver, bring a signed hard copy to OCHN.
Click the link below to view the Wellness Center orientation video.
By checking the box below, you certify you have viewed the orientation video in its entirety.
Send me a copy of my responses
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