We are excited to be serving both Orange County and San Diego! Please use the SIGN UP HERE button below to submit your intake and get started. Once we receive your paperwork we will reach out for scheduling. Our office staff is only in a few days a week, so please give up to 5 days for processing,
*Please note the online form does not include the liability release, so we will email this to you after receiving your intake or you can download below and email to email@example.com .
Please complete and return (from forms to download below)
1. Intake Packet
2. Liability Release
3. Media Release
to firstname.lastname@example.org to get started today! In the subject please include if you are interested in our Orange County or San Diego based programs!
If you want to keep a card on file for payment, please also return the card on file authorization form.
No individual should miss out on therapeutic opportunities because of financial need. A financial aid application is available below. Please read the instructions fully and return it to email@example.com to determine eligibility or assistance in covering treatment fees for services.