Southern Illinois

Get started with services in Southern Illinois

Included locations: Belleville, Granite City, Maryville, and Wood River, IL

Getting started with services—or completing required paperwork—in Southern Illinois is simple and convenient with our online forms.

Whether you're new to Chestnut or continuing care, you can quickly find and complete the forms you need below.

What to Expect

• Forms can be completed securely online at your convenience. They are HIPPA compliant and all your information is secure.
• Most forms take five to ten minutes to complete online.
• After forms have been verified, you will be contacted by our team to schedule an appointment (1-2 business days).

Need Assistance?

If you're unsure which forms to complete or need help getting started, we're here to help.
Contact us at 888.924.3786 or fill out this form and a member of our team will guide you.

Start Services or Complete Required Forms

Select the category that best matches your needs. Forms are organized by age group.

• Adults (Ages 18 and older) Start Here
  Complete these forms for adult services, including intake, assessments, and program participation.
• Adolescents (Ages 12-17) Start Here
  Complete these forms for adolescent services. These forms require a parent/guardian signature.
• Children (Ages 11 and younger) Start Here
  Access intake forms, consent documents, and service-related paperwork for youth. This form requires a parent/guardian signature.

Don't want to complete your forms online?

Download and complete the required paperwork below.