Forms
REGISTRATION SHEET AND CONSENT FOR TREATMENT
Download Registration Form (pdf)
Download MEA Cares Employee Assistance
Program – Informed Consent (pdf)
Download MEA Cares Counseling – Informed Consent (pdf)
Notice of Privacy Practices
Copy of our Notice of Privacy Practices
Office Hours:
Monday – Friday,
8am- 5pm
Ridgeland and Jackson
Contact Information:
For more information
or to set up an
appointment with
a Counselor,
call (601) 898-7520 or
1-800-844-6503.
Patient Satisfaction Survey
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs.
Please know all responses will be kept confidential and anonymous.
NOVEL CORONA VIRUS (COVID-19)
WHAT DO I DO IF I MIGHT HAVE COVID-19
If you are experiencing symptoms of respiratory illness (fever, coughing or shortness of breath) or answer yes to either of the following questions, contact your primary care physician for guidance.
If you do not have one, call one of the numbers below to schedule an appointment with a primary care physician.
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Have you been in contact with anyone confirmed or suspected of having coronavirus/COVID-19 in the last 14 days?
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In the last 14 days, have you traveled to an area with sustain community transmission of COVID-19 (Europe Asia New Orleans or others)?
St. Dominic‘s Family Medicine
Scheduling Center
601-200–5000
Monday – Friday 8am to 5pm
MEA Medical Clinics
601-898-7540
Monday – Saturday 9am to 5pm
Copyright © 2023 - MEA Cares Counseling