Patient Forms

How To Become A Client

Individuals wishing to participate in Progressive Counseling’s Addiction Recovery Program may contact the Center directly to schedule an assessment: 330.629.2434

PATIENT FORM: ONLINE  |  PDF


Physicians may refer patients needing Addiction Recovery and Counseling Services at 330.629.2434
Note: Please see the Physician Referral Form (PDF)


Mental Health Client Forms

Addiction Client Forms


Program Requirements
  • Participants must have a realization that a change must occur. The programs are tailored to your needs and you must show a commitment to change.
  • Individuals must be willing to participate in a highly-disciplined addiction recovery treatment program that could include:
    1. Buprenophine (ex. Suboxone, subutext, sublocade) or vivitrol medication.
    2. Mandatory individual and group counseling sessions.
    3. Regular and active participation in a 12-step program Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) or other support activities.

Payment Options

Now accepting a variety of payment options including:
VISA | MASTERCARD | DISCOVER | SELF PAY

Insurance

Most major insurance plans cover a majority of treatment costs and are different depending on your insurance coverage.

NOTE: Progressive Counseling Center is continuously expanding our insurance provider list. Please contact our office to learn if your insurance plan is accepted. 330.629.2434