If you are interested in joining us for any programs (waivered or non waivered services), please fill out the Intake Application and HIPAA Form attached below.
*Once, your paperwork has been approved, you will receive a confirmation and be able to register for programs through LeagueApps.*
*Please fill out all questions completely, as well as attaching additional paperwork when sending in the Intake Application and HIPAA Form*
Send the Intake Application, HIPAA Form and additional paperwork to
Email: Igendron@cprochester.org.
If you have any specific questions about the forms, you may also contact via office phone.
Phone: (585) 334-6000 x2281
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