INTAKE QUESTIONNAIRE

Please be aware that we have had some issues with applications that have been completed on smart phones.  It is best to use a tablet, laptop, or computer.  Please complete all fields.  Many are mandatory and by leaving them blank your application will not be sent.  If you don’t know an answer, please put n/a in that field.  You will receive the following notification on your screen if your application is complete and submitted:

“Your intake application has been submitted successfully.”