We’re excited to support your family on your journey toward growth and success. To begin services, please complete the necessary forms below. Our team will review your submission and reach out to guide you through the next steps.

Step 1: Submit an Interest 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.

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

We look forward to working with you and supporting your child’s development!

Our Forms

Information Updated Document

Intake Document

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Address:
138 W Chelten Avenue, Philadelphia, PA 19144

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Fax:
(855) 763-1612

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Email:
inquiry@lwbehaviorservices.com

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Telephone:
(877) 761-6331