IMPORTANT FORMS
PHONE: 785-691-5653
EMAIL: tonidetherage@gmail.com
Referral Forms
For your convenience we have our referral form online.
This gets us the information a lot faster and saves you time!
This gets us the information a lot faster and saves you time!
If you're having trouble completing the referral form online, you may download a PDF version of the form. Then, email it to tonidetherage@gmail.com or mail it to FCTPS, 211 E. 8th Street, Ste. B, Lawrence, Kansas, 66044
| referral_form.pdf |
Authorization to Release Information
To get a release form, just click on the button below to download the authorization to release information form. Then, email it to tonidetherage@gmail.com or mail it to FCTPS, 211 E. 8th Street, Ste. B, Lawrence, Kansas, 66044