Complex  Care Intervention
Intake Form


Confidentiality is paramount in the Complex Care Intervention process. Your personal information shared in this intake form will be kept strictly confidential within our therapeutic team. We prioritize creating a safe and supportive environment for your child’s healing journey, and your trust in our confidentiality measures is crucial to the therapeutic relationship.

Please review the available funding options before filling out the intake form and confirm your funding sources. To view funding options, please see Funding Options