The Intake Process

1. Click on the link below to download our intake request form.

Intake Request Form

Complete the form and send it to us by fax or email:

Fax: (603) 760-1949      Email:

IMPORTANT: After sending in the intake request form, a parent/guardian must call our intake line at (603) 760-1942 x309 to start the intake process.

Our intake coordinator will review your request and call you to discuss next steps. We will contact your insurance carrier to determine if your plan is covered and to check your benefits. Please note that we receive a large volume of intake requests and respond to them in the order they are received.

If your child is anxious about starting our program or unsure if they are willing to attend, we encourage you to do a walkthrough of our office prior to scheduling an intake. A walkthrough is a brief (15-minute) tour of the facility and opportunity to meet our staff and ask questions. Walkthroughs are offered most days of the week at 11:30am or 11:45am. To schedule a walkthrough, please call our front desk.

2. Complete Forms and Schedule Intake Appointment

We ask that all clients with access to email complete their intake forms electronically via our client portal. You will receive a welcome email with a link to register for a free client portal account. Registration is easy—simply create a username and password. You will receive a second email with a link to your intake forms, which will allow you to log in to the portal, electronically sign, and submit all of your intake forms. Please be aware that the Adolescent Health History form is lengthy (45 minutes to complete, on average) and must be completed in one sitting (you cannot save and return to finish it later). Once your paperwork is complete, we will contact you to schedule the intake appointment.


3. Attend the Intake Appointment

Please note that all intake appointments — for both our virtual and in-person programs — are done virtually via Zoom. We will first ask your child if they are willing to attend our program, because it is 100% voluntary. The child and parent/guardian will then meet individually and together with one of our clinicians, who will ask questions about the child’s symptoms and history in order to make preliminary diagnoses, assess safety, and determine if the child meets criteria for our level of care. If your child is admitted, they will start the program the following day. The appointment lasts an average of 90 minutes.