INTAKE REQUEST
Welcome to our new intake portal which allows you or members in the related services industry to submit an online emergency request for housing services, mental health services, or instructional training. Please complete the form below and a member of our team will contact you within 72 hours. Please be advised, all information submitted is confidential and any medical responses received are protected by HIPPA especially as our facility does adhere to HIPPA confidentiality laws/policies. Since we are a boarding house program, we must exercise cautions against communicable diseases and other pubic health issues. Therefore, interested participants may be required to secure medical testing/screening at one of our partnering health facilities. Lastly, new incoming participants are required to pay a $175.00 non-refundable admission fee which covers standard program materials, supplies, and onboarding processing. Acceptable forms of payment will be determined if intake request is approved.