Behavioral and Mental Health Services Request

Para completar este formulario en español, haga clic aquí.

All information provided in this form will be submitted directly to the Behavioral and Mental Health Service of Alexander Jewish Family Service and will be kept strictly confidential. All requests submitted will be followed up by phone or email.

Alexander JFS seeks to provide services to over 30 surrounding zip codes. To maintain the best, ethical and clinical practice, and to ensure greatest level of confidentiality to protect our clients, Alexander JFS employees, Alexander JFS board members, and/or their family members will be referred elsewhere for most services. Alexander JFS intake staff members will assess, consult and make appropriate referrals for those that we cannot directly serve.

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