Office Locations

(541) 942-3939

Forms

Restore Hope, Renew Lives

Forms

         Release of Information (ROI) Forms

South Lane School District ROI (Youth Only)
Blank School ROI (Youth Only)
Emergency Contact ROI (Primary)
Peace Health ROI
Umpqua Health Alliance ROI (UPH ONLY)
Blank Medical ROI
Blank ROI
SUDS ROI

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Cottage Grove - Main Office

1345 Birch Ave
Cottage Grove, OR 97424
M – W & F 8am – 5pm
Thurs 8am – 6pm
541-942-3939
Fax: 541-942-9310

Bohemia Residential Center (Adult Foster Home)

1115 W Main Street
Cottage Grove, OR 97424
541-942-3939

Downtown Building

37 N 6th St
Cottage Grove, OR 97424
541-942-3939

East Building

1245 Birch Ave
Cottage Grove, OR 97424
541-942-3939

Island Park

288 Mill Street
Springfield, OR 97477
541-942-3939

Recovery Center

75 S 5th St.
Cottage Grove, OR 97424
541-942-3939
Fax: 541-649-1697

Intake Scheduling Form

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