Forms

Step 1: Submit an Intake Form

If you are interested in our services, please fill out our Service Interest Form to provide us with basic information about your child and their needs.

Step 2: Complete Required Documents

To move forward with services, we require the following documents to be completed and submitted:

Release of Information Form

Authorizes us to communicate with other providers involved in your child’s care.

Consent to Treatment Form

Grants permission for your child to receive behavioral health services.

Our Forms

RELEASE OF INFORMATION FORM

INTAKE DOCUMENT

What Happens Next?

Once we receive your forms, our team will review your submission and reach out to discuss:

Eligibility & Insurance Verification

Service Options & Scheduling

Next Steps for Enrollment

If you have any questions or need assistance completing the forms, please contact us at:

(877) 761-6331

inquiry@lwbehavioralservices.com

Mission Statement

Laila’s Way Behavioral Services’ mission is to help the community build skills for independence, employment, and a meaningful life.

OUR SERVICES