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Admissions Process and Application Forms to be Completed

In order to complete the first phase of the admissions process, please complete and submit the three forms below and read the Resident Involvement section. Upon completion of the forms and receipt of all relevant past treatment records, the application will be reviewed in-full and we will contact you with next-steps within 24 – 48 hours.

Please contact any hospitals or residential programs where the individual formerly received treatment within the last two years and have those discharge summaries sent to our admissions team.

Direct Admissions Line: (828) 894.7140

Fax: (828) 894.7111
Email: info@coopperriis.org

 

CooperRiis application forms:

Treatment Team Form (PDF): The referring psychiatrist and/or other licensed mental health professional(s) working with the applicant complete and submit this form.

The Family Form (PDF): this form describes the family’s responsibilities and is completed by the applicant’s immediate family, consisting of parents, spouse, sibling and/or guardian.

The Physical Form (PDF): to be completed by a medical professional.

Admissions Checklist 

  • The Treatment Team Form (PDF)—To be completed by referring psychiatrists and/or other licensed mental health professional(s) working with the applicant
  • The Family Form (PDF)—To be completed by the applicant’s immediate family (parents, spouse and/or guardian)
  • The Physical Form (PDF)—To be completed by a medical professional
  • The Resident Form (PDF)—Each applicant is encouraged to participate actively in the admissions process. We would like the applicant to describe, in their own words, their concerns, their hopes and their goals. This form can be either filled out by the applicant or discussed in conversation with an admissions staff member *Optional*
  • Records
  • Discharge Summaries from past Psychiatric Hospitals and/or programs
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