Forms

Listed below are links to forms that you may need to use the services of Corner House. The forms are all in Adobe Acrobat (PDF) format. If you need to install the Adobe Reader software on your computer, you can find it here...

DAS Income Eligibility (DASIE)
The full fee of counseling services at Corner House is $100.00 per session. Funding is available from the NJ Department of Human Services (Division of Addiction Services), allowing our agency to adjust payments for eligible clients on a sliding fee scale based on income and family size. To determine your eligibility to receive public funding for substance abuse treatment, you must complete this Income and Eligibility screening. Your household income must be at or below 350% of Federal Poverty Level to qualify for DAS-funded services at our agency. Otherwise, you will not be eligible for public funding. You will be required to submit proof of gross earned income and/or any other income received.