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Register today for the annual TASC Leadership Awards Event on June 6th at the Bridgeport Art Center.

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700 S. Clinton St. Chicago IL 60607

1 855 827 2444

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.