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Newtown Intake Application

  • Use the link below to save the application to your desktop
  • Close the website and open the document from your desktop
  • Please be sure to answer all questions and provide all of the information requested
  • Save the document
  • Click the “submit” button to send via email
    • If it fails to send, attach it to an email and send to
    • Alternatively, print and mail it to the address at the bottom of the application or by fax
  • We will review your application and contact you

There will be a $40 application processing fee due on or before the first meeting. In some very limited cases the fee may be waived.