Intake Forms

In preparation for your first intake meeting with us, please take a few minutes to download and complete the forms below. Include a scan of your ID and insurance information front and back. Click the link below to learn more about What to Expect in your first appointment.

In preparation for your first intake meeting with us, please take a few minutes to download and complete the forms below. Include a scan of your ID and insurance information front and back. 

If you would like to check the status of your paperwork please call us at 303-853-3445. If you are not able to print these, forms are available at any of our offices. Forms are available in both English and Spanish.

You can turn completed paperwork in via email at intake@communityreachcenter.org, by fax: 303-487-7240, or in person.

Please bring an ID, insurance information, and financial information with you to your intake. If the client who is being assessed for services is under the age of 15 and you have either joint or primary custody, proof of legal guardianship must be presented at your intake assessment.

If you need to schedule an intake appointment at a time not listed below, please call: 303-853-3445. Thank you!

Locations Providing Intakes:

Early Childhood Services
8889 Fox Dr. Thornton, CO 80260
Please call to schedule your intake.

Broomfield Outpatient
100 Spader Way, Suite 267 Broomfield, CO 80020
Please call to schedule your intake.

Thornton Outpatient
8931 Huron St, Thornton, CO 80260
Walk-ins are accepted on Mondays from 12-2 pm and Tuesdays from 8-10 am.

Brighton Outpatient
1850 East Egbert Street Ste. 200 Brighton, CO 80601
Walk-ins are accepted on Wednesday 8-10 am.

Westminster Outpatient
3031 West 76th Ave. Westminster, CO 80030
Walk-ins are accepted on Wednesday 8-10 am.

Northglenn Outpatient
11285 Highline Dr, Northglenn, CO 80233
Walk-ins are accepted on Friday 8-10 am.

PDF downloads:

 

Online registration:

Please use a black ink pen to complete the form.

Intake Forms—Adult English

Intake Forms—Child English

Intake Forms—Adult Spanish

Intake Forms—Child Spanish

We look forward to seeing you soon!