Intake Form

If you are a youth over the age of 16 who would like to access our services please fill out this form

Legal Name(Required)
Guardian/Caregiver Name if under 16
If you are under 16 years old, please provide guardian/caregiver information so the STEP Staff is able to schedule an appointment for you.
Preferred contact method(Required)
Do we have permission to leave a voice message?(Required)