Consumer Forms

The following forms are for LUK Clients and Participants while taking part in services at LUK, Inc.:

pdf After Hours Procedure (106 KB)

pdf Authorization to Use and Disclose Health Information (248 KB)

pdf Client's Acknowledgement of Receipt of LUK Policies (207 KB)

pdf Client Grievance Handout (109 KB) /

pdf Client Rights (662 KB)

pdf Client Rights and Grievance Acknowledgement (79 KB)

pdf Communicable Disease Policy (118 KB)

pdf Confidentiality Policy (121 KB)  |  pdf Política de Confidencialidad (104 KB)

pdf Derechos del Cliente (131 KB)

pdf Human Rights (2.44 MB)

pdf New CANSConsentForm (70 KB)

pdf Notice of Privacy Practices 06 26 18 (267 KB)

pdf Program Handbook Partnering for Progress (231 KB)

pdf Records Release Form Adult Web

pdf Records Release Form Minors Web (272 KB)

 

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LUK, Inc. is a 501(c)(3) nonprofit organization, EIN 04-2483679. Donations are tax-deductible to the fullest extent allowed by law..