The HEC program my child is in is:     Brookside Intensive Treatment Unit

5 Ramsdell Road

Great Barrington, MA 01230

 

My child’s Treatment Team is Team __________________________.

 

The program’s phone number is (413)528-0535

 

My child’s Clinician’s name is ______________________________________________.

 

His/her telephone extension is Extension_________________________.

 

His/her supervisor’s name is ______________________________.

 

His/her supervisor’s telephone extension is Extension ___________.

 

The Program Director’s name is ________________________________________.

 

His/her telephone extension is Extension__________________________.

 

The telephone extension for the Nurse’s Office is Extension _______________.