Group Intake Request Form

Thank you for your interest in ITTC’s groups. Please complete the information below and someone from our office will contact you soon for an initial assessment appointment. Thank you!

This form is powered by Hush™ Secure Forms, ensuring compliance with HIPAA regulations. If you require any specific assistance while completing this form, please feel free to contact us at (971) 266-6910, and we will be happy to assist you.

ITTC is no longer accepting new clients for medication management.