Intake Forms


Community Reach Center Intake Forms - Become a Patient - Woman holding pen signing agreement document

Welcome to Community Reach Center! Your first session with us is called a "New Admission" meeting. Please click on What to Expect to understand what will take place at this meeting. We offer new admission meetings on a walk-in basis, 5 days a week from 8-3pm first come, first serve.

In preparation for your first intake meeting with us, please take a few minutes to download and complete the forms below. You may find it easier to complete these forms at home where you have all your information available. However, if you are not able to print these, forms will be available when you arrive at one of our offices. Forms are available in both English and Spanish.

Please bring authorization paperwork to walk-in intake or - if you prefer - a scheduled intake.

Please use a black ink pen to complete the form and do not fill in the date on the form until you arrive for intake.

Intake Forms—Adult English

Intake Forms—Child English

Intake Forms—Adult Spanish

Intake Forms—Child Spanish

We look forward to seeing you soon!