NEW PATIENT FORMS
New Patients, Welcome to Mathers Clinic - The First Step Is Reaching Out
We understand that reaching out for help can be a difficult first step. You have made a positive step toward emotional healing and growth. At Mathers Clinic, be assured that we have taken great care in selecting an exceptional team of professionals to meet your needs.
This guide will help you become familiar with our practice. Our caring and highly qualified professional staff offers a wide range of services.
Existing Patient Login - PATIENT PORTAL
Mathers Clinic Forms
Please download, print and fill out the forms below. You will need to bring them to your first visit to our office. Do you need Adobe Acrobat Reader DC? It's free – CLICK HERE.
- New Patient Registration Form
- Informed Consent for In-Person Services During COVID-19 Public Health Crisis
- Missed Appointment Policy Form
- Mathers Financial Policy
- Client Rights Form
- Privacy Practice HIPPA Form
- Release of Information Form
- Email Consent Form
- Text Message Authorization Form
- Additional Information Form
*Important Information About Your Insurance Coverage* (Web page, not a PDF)
For Those Seeking Suboxone Treatment Services
Please download, print and fill out the forms below. You will need to bring them to your first visit to our office. Do you need Adobe Acrobat Reader DC? It's free – CLICK HERE.
- Buprenorphine Maintenance Treatment Agreement Mathers (PDF)
- Buprenorphine Treatment Contract-Mathers (PDF)
- Drug Screening Policy Agreement (PDF)
- Clinical Opiate Withdrawal Scale (COWS - PDF )
Contact Mathers Clinic
Contact us to schedule an appointment with a psychiatrist or for more information about our services by calling (815) 444.9999. You may also email us at info@themathersclinic.com. We look forward to helping you meet with a psychologist at a time that works well for you.
815.444.9999 |
The hardest part was finding the courage to pick up the phone to setup an appointment. Everyone at Mathers Clinic is so easy to talk to making it easier for me. Now I look forward going to my sessions, knowing that I am taking steps to move forward with my life. Call 815.444.9999 today!
Respectfully Caring for the Emotional Well Being of Individuals & Families.
Crystal Lake Office
145 South Virginia Street
Crystal Lake, Illinois 60014
phone: 815.444.9999
fax: 815.986.1363
Crystal Lake Business Hours
Monday 8:00am - 7:00pm
Tuesday 8:00am - 7:30pm
Wednesday 8:00am - 6:00pm
Thursday 8:00am - 5:00pm
Friday 8:00am - 5:00pm
Saturday 9:00am - 12:00pm
Sunday Closed
Woodstock Office
715 West Judd Street
Woodstock, Illinois 60098
phone: 815.444.9999
fax: 815.986.1363
Woodstock Business Hours
Monday 9:00am - 5:00pm
Tuesday 9:00am - 7:00pm
Wednesday Closed
Thursday 9:00am - 7:00pm
Friday 8:00am - 5:00pm
Saturday Closed
Sunday Closed
Mathers Community Mental Health Center Affiliates:
THE MATHERS RECOVERY
Federally licensed facilities for opiate/opioid treatment. Full range service for detoxification.