386.492.6938 • 386.212.3634
209 Dunlawton Avenue, Unit 16 • Port Orange, FL 32127
FAITH • HOPE • LOVE
CONFIDENTIAL INTAKE FORMS [click to view and print]
We invite you to print and complete the confidential Intake Forms prior to your initial appointment.
The Intake Form is also available at our office and you may complete it there if you prefer.
If so, please arrive 15 minutes prior to your scheduled appointment time.
The following links are listed to provide you with additional online mental health information and resources.
Florida Abuse Hotline 1.800.96.ABUSE
Suicide & Crisis Hotlines 1.800.273.TALK (8255)
Center for Autism and Related Disabilities
National Eating Disorder Association
Adolescents and Self-Cutting (Self-Harm): Information for Parents
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