PAPER REGISTRATION
Registering using our paper forms is as easy as 1-2-3:
Review our Orientation Paperwork
Download and review the Orientation Packet from the Supporting Documents listed below.
Complete the Registration Form
Download and then print the Registration Packet from the Supporting Documents listed below.
Mail or Drop off your Registration Forms
BY MAIL:
ATTN: Intake Department
Polk County Behavioral Health
182 SW Academy Street
Dallas, OR 97338
DROP OFF: Hours & Location
Supporting Documents
Release of Information (562 KB) Orientation Packet (356 KB) Registration Packet (2 MB) Spanish - Release of Information (476 KB) Spanish - Orientation Packet (371 KB) Spanish - Registration Packet (849 KB) 