INTAKE

A completed intake application is required upon placement confirmation. Please download and complete our fillable intake package. If available, please include the most recent Genogram, Eco-Map, Concurrent Plan (and any service or safety plan that is currently active at the time of intake), include the most recent Ongoing Assessment (OA), copies of recent report cards, any assessments (educational, psychological, etc.) completed on the child and any relevant health records.
Please submit the Intake Application by email or fax.
 
Please download the intake application below and have it sent by email or fax.
Email: info@jsemine.com
Fax: 587 985 5328 

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