We assure you that all provided information will be treated with utmost confidentiality and in compliance with legal and ethical guidelines. It will only be shared with our intake coordinator and therapy team members involved in care. This referral does not guarantee care.
Thank you for providing the necessary information to support the survivor's journey toward healing and recovery. Please submit this completed form and notify the guardian or client that our intake coordinator will be in contact with them.
If you have any questions or need further assistance please email us at support@teenswithtrauma.com or call or text us at 443-377-3021.