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HOME > INTAKE FORM
AIS Intake Form

Download our intake form to start the process of creating a case with Adolescent Intervention Services.

AIS Intake Form (RTF Format)

Please fax or email the completed form to:

Fax: 240-213-0212
Email: info@adolescentintervention.net
Attn: George Pineda

Once we receive the completed form an A.I.S. member willl prepare and send your Transport Documents for your review and signing.


Please feel free to contact us by email or phone if you have any questions.

Email: info@adolescentintervention.net
phone: 301-885-1999
toll free: 1-866-6AISAIS (1-866-624-7247)
adolescent intervention services, residential treatment, families in crisis, troubled youth, clinical social worker, AIS, ais, George Pineda, David Levin
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