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NV Intake Packets

NV intake packets are currently only available in English.

Adolescent Intake Packet (ages 10 - 18)

Form Format
NV Intake Top Sheet .

Youth Questionnaire

 .
Parent Questionnaire .
Release of Information .
NV Income Verification Sheet .
Fee Scale for individual Sessions .
Fee Scale for Group Sessions .
Fee scale for Intensive Outpatient sessions .

Adult Intake Packet (Ages 18 - over)

Form Format
NV Intake Top Sheet .
Adult Intake Packet .
Release of Information .
NV Income Verification Sheet .
Fee Scale for individual Sessions .
Fee Scale for Group Sessions .
Fee scale for Intensive Outpatient sessions .

 

 

Tahoe Youth & Family Services
1021 Fremont Avenue, South Lake Tahoe, CA 96150   |   530-541-2445
1422 Mission St., Gardnerville NV 89410  |  775-782-4202

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