Thank you for taking the time to complete the Intake Survey. Your thoughts are very important to us and vital in maintaining the best client experience.
You will need your “Client ID Number” to start. Simply ask one of our staff members if you do not already have your “Client ID Number”.
Note: The system will only allow one Intake Survey per client.
All of our services are offered at each of our three convenient locations in Broward County, Florida. Whether you are seeking mental health counseling, anger management help, or drug and/or alcohol addiction treatment, visit one of our South Florida locations in Plantation, Pompano Beach, or Miramar.
Select the option that suits you best: in-person appointments provide face-to-face interaction and a comfortable space for sharing, while online appointments offer the convenience and flexibility of meeting from wherever you are.
Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.
By submitting you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.
