Intake & Consent: Adult
We are delighted that you have chosen to embark on this journey with us. Completing this intake form is the first step towards creating a supportive and personalized experience tailored to your needs. Your comfort and well-being are our top priorities. The information you provide will help us understand your unique situation and how best to support you. Rest assured, everything shared here is kept confidential, and we encourage you to take your time as you fill out the form. If you have any questions or need assistance at any point, please don’t hesitate to reach out. We are here to support you every step of the way.
Please note the following:
- There are two places where a signature is required, which you can do easily from any mobile device, tablet or computer.
- Fields do not save and the form must be completed in one sitting. It will take about 10 mins to complete.
- Click Submit when done.
If you have any issues or questions about this form please contact our office.