Individual Adult Intake

Individual Adult Intake Form

The Individual Adult Intake Form may be Previewed here.

Before submitting any forms we ask that you have a phone screening with an intake counselor. Please call 310-271-9999.

*For Couples Therapy, we would like each partner to complete an Individual Adult Intake Form.

There are 3 different options to submit the Intake Form.

    1. Download PDF application, print, sign, scan, and email the completed application to
    2. Electronically complete through DocuSign with a digital signature. Once completed you will receive a copy of the completed forms and someone will be in contact with you to schedule an Intake appointment. 
    3. Call our office to receive an application by mail and once completed mail it back to TMCC. 


Your Intake Appointment will be scheduled once your completed application has been received and you have paid the Intake fee.