Online Forms

We know time is important to you. Our intake forms are available for you to print out, fill out and bring to your first appointment.

For all adults, print the Adult Intake form.

For all children 5 years and younger, print the Youth Intake form.

For all children 6-18 years old, print the Child Intake form.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

  • Download the necessary forms, print it out and fill in the required information.

  • Fax the completed form(s) to (570) 858-5083 or bring the form(s) with you to your appointment.