Client Forms

Please carefully review the following documents as they pertain to you or your child’s treatment. Please direct any questions you have regarding these documents to the front desk staff by calling 308-236-0500 or e-mailing officemgr@midwestecc.org.

For new client requests, please submit the MECC Referral Form and we will be in touch.

MECC Referral Form
MECC Referral Form (PDF)
MECC Consent to Release Information (PDF)