Common Forms and Literature

front view of building

We have compiled some of our most commonly requested forms and literature on this page for your convenience.

Other forms may be available on separate web pages or by direct request. If you are looking for a download that you do not see here, please visit Contact Us to submit a request.

Release of Information Forms

Release of Information Form

You can email your completed Release of Information request form to the North Central Health Care Health Information Services department at NCHCMedRecords@norcen.org or mail your request to:
North Central Health Care
Attn: Health Information Services
2400 Marshall Street, Suite A
Wausau, WI 54403

Referral Forms

Behavioral Health Services Referral Form

Behavioral Health Services Referral Instructions

Aquatic Therapy Referral Form Download

Child/Adolescent Psychiatry Packet

Aquatic Services

Aquatic Therapy

Aquatic Therapy Rules & Attendance

Addiction

Outpatient Services – Substance Abuse and Addiction Treatment

Outpatient Services – Substance Abuse and Addiction Treatment (Hmong)

Outpatient Services – Substance Abuse and Addiction Treatment (Spanish)

Outpatient Services – Substance Abuse Day Treatment

Outpatient Services – Substance Abuse Intensive Outpatient Program

Hope House (Wausau & Antigo)

Hope House Wausau

Hope House Antigo

Lakeside Recovery

Community Treatment

Children’s Long Term Support and Children’s Community Options Program

Community Treatment Brochure

Community Treatment Brochure (Hmong)

Community Treatment Brochure (Spanish)

Community Treatment – IPS Supported Employment

Community Treatment – Youth Services

Crisis Services & Inpatient Mental Health

Youth Behavioral Health Hospital - Inpatient Care

Emergency and Crisis Services

Emergency and Crisis Services (Hmong)

Emergency and Crisis Services (Spanish)

Youth Crisis StabilizationFacility

Adult Crisis StabilizationFacility

Crisis Response Team (CART) (Marathon County)

Developmental Disabilities

Adult Day Services – Antigo

Outpatient Services

Outpatient Services – Mental Health

Outpatient Services – Mental Health (Hmong)

Outpatient Services – Mental Health (Spanish)

Outpatient Services – Substance Abuse Day Treatment

Outpatient Services – Substance Abuse Intensive Outpatient Program

Outpatient Services – Substance Abuse and Addiction Treatment

Outpatient Services – Substance Abuse and Addiction Treatment (Hmong)

Outpatient Services – Substance Abuse and Addiction Treatment (Spanish)

Outpatient Services – Counseling in Schools
All Forms for Counseling in Schools found at www.norcen.org/CounselingInSchools

Outpatient Services – Telehealth

Policies for Payment of Fees

Policies for Payment of Fees (English)

Policies for Payment of Fees (Hmong)

Policies for Payment of Fees (Spanish)

Patient, Client, Resident Rights & Responsibilities

Patient, Client, Resident, Rights and Responsibilities (English)

Patient, Client, Resident, Rights and Responsibilities (Hmong)

Patient, Client, Resident, Rights and Responsibilities (Spanish)

State of WI Rights Specific to Children and Adolescents

Rights of Children and Adolescents in Outpatient Mental Health Treatment

Rights of Children and Adolescents in Outpatient Mental Health Treatment (Hmong)

Rights of Children and Adolescents in Outpatient Mental Health Treatment (Spanish)

State of WI Rights and Grievance Resolution Procedure for Inpatient and Residential

Client Rights and the Grievance Resolution Procedure for Inpatient or Residential Services

Client Rights and the Grievance Resolution Procedure for Inpatient or Residential Services (Hmong)

Client Rights and the Grievance Resolution Procedure for Inpatient or Residential Services (Spanish)

Skilled Nursing

How to Choose a Nursing Home

Dementia/Memory Care

Long-Term Care

Short-Term Rehabilitation

Ventilator Dependent Care

Transportation Services

Marathon County Transportation Program (MCTP)

Volunteer Services

Volunteer Services