Thank you for choosing the Anger Management Intervention Program at Lake-Geauga Recovery Centers, Inc. This program was designed to help individuals who have a difficult time controlling their anger by teaching tools to identify anger cues and triggers along with diversion techniques.  To increase the individuals’ awareness of their personal patterns and behaviors regarding anger, and to assist them in developing an anger control plan.

• To be FULLY registered, payment must be included with this registration form. Registration deadline is 48 hours before the day of the program, or when the program is full. Please call to check on program status.
• The registration fee is $60.00.
• You may register and pay on line at www.lgrc.us.
• Or you may send cashier’s check or money order (payable to Lake-Geauga Recovery Centers) with registration form to the:
  Lake-Geauga Recovery Centers, Attn: Education Program
  9083 Mentor Avenue,
  Mentor, Ohio 44060
• Credit card will be accepted in person at the above address from 8:00 AM – 7:00 PM Monday through Thursday, and 8:00 AM – 3:00 PM Fridays. Please call in advance to check for holidays or office closings.
• No Personal Checks will be accepted.
• Upon receipt of your registration and fee, a confirmation letter containing program date, instructions and guidelines will be mailed to you. At this time, your information maintained by this program is protected by federal laws and regulations as per the Confidentiality/Privacy Rule below.
• If you do not receive a confirmation letter, it is your responsibility to notify Lake-Geauga Recovery Centers. Call 440-255-0678 if you have any questions.
• Your registration fee is non-refundable after scheduling. If you do not attend, you will forfeit your fee. A rescheduling fee of $15.00 will be required before being accepted into another program date.
• If you are referred to this program by an agency, court, employer, etc., it is your responsibility to ensure the program fulfills those requirements.
• Once registered and a release of information has been signed to your referral source, that entity will be notified if you do not show for sessions.
• Upon completion of all 6 classes, you will receive a certificate of completion.

I understand that my records are protected by federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2 and cannot be disclosed without my written consent unless otherwise provided for in the regulations. Drug abuse patient records are also protected under the Health Insurance Portability Act of 1996 (HIPAA), 45 C.F.R., parts 160 and 164. The HIPAA Privacy rule provides individuals the right to request confidential communications or that a communication of PHI is made by alternative means, such as sending correspondence to the individual’s office instead of the individual’s home. The Privacy rule generally requires healthcare providers to take reasonable steps to limit the use or disclosure of, and request for PHI to the minimum necessary to accomplish the intended purpose. These provisions do not apply to uses or disclosures made pursuant to an authorization requested by an individual.