Telehealth: Client Forms & Resources
Whether in person or remotely via telehealth, TASC is committed to serving our clients. If you are a current TASC client, please contact your TASC case manager directly. You may also contact our administrative offices via email or phone.
If you or someone you know may need help, please contact your local TASC Area Office, or call us at 1-855-827-2444.
TASC Client Intake Forms
(TASC staff will help explain these forms to you.)
Form 1: Client Consent
Form 2: Guarantee of Payment
Form 3a: Individual Authorization
Form 3b: Group Authorization
Form 4: Permission for Communication
Form 5: Telehealth Consent
Client Rights Statement
Notice of Privacy Practices
Information on COVID-19 (coronavirus)
COVID-19: Frequently Asked Questions - from Illinois Department of Public Health (IDPH)
COVID-19: Latest Guidance - from Chicago Department of Public Health (CDPH)
COVID-19: How to Protect Yourself and Others - from Centers for Disease Control and Prevention (CDC)
Resources for Crisis Assistance and Recovery Support
Emergency services in Illinois and online recovery support - TASC 1-pager
Illinois Dept. of Human Services Digital Recovery Support Resources Toolkit - Virtual recovery support communities, mental health resources, and more
Illinois Domestic Violence Helpline - 1-877-863-6338 (Voice) 1-877-863-6339 (TTY) Toll-free, confidential, multilingual, and open 24 hours
Illinois Medicaid and all medical assistance - Apply or re-apply online to avoid long wait times on the phone
US Government Benefits - Links to government benefits, food assistance, help with bills, unemployment assistance, and more
Winners' Circle Facebook Group - Facebook group offering peer support for facing life struggles
For more information, including peer recovery support resources, see our Client & Community Resources page.