Innovation • Excellence • Compassion


Admission Request

Thank you for your interest in our programs. Please complete and submit the admission request form on this page and a member of our staff will contact you.

This information will be entered into our computer database. Please note that we do not use a waiting list. That means that children are not admitted on a first come first serve basis. Rather, when we have an opening, we consider the needs of the students we currently serve and the needs of the children in the database and try to make the best match. You are welcome to make a request for intake at any time. Submission of a Request for Intake form may not necessarily result in an intake or subsequent placement.

Intake Request Form

What program(s) are you interested in? * :
Education Program
Business Academy
Adult Program
Outreach Program
Social Skills Group
Other Clinical Services

Child's Gender * :

Preferred Contact Method * :
Home Phone
Cell Phone

Please also send me information about :
Social Skill Groups
Clinical Services
Education Program
Adult Services

* Required
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