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Register for
Los Angeles June 8 – June 26 (waitlist only)

Jun 08 - Jun 26, 2020

Los Angeles June 8 – June 26 (waitlist only)

https://www.napacenter.org/events/los-angeles-june-8-june-26/

  • Jun 08 - Jun 26, 2020
  • 11840 S La Cienega Blvd, Hawthorne, California 90250, USA

Registration Request

This form is a request to sign up for an intensive session. Your session will not be confirmed until you receive an email with a tentative schedule and place a deposit for the session booking.

Intake forms

Not sure what therapies you should be requesting for? Before filling out our registration form, you must first fill out the intake paperwork below. Once you do, our team of therapists will determine what type of therapies and how many hours are appropriate for an intensive session.

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Apply for this session.

Patient Information

Patient Name*
Parent / Guardian Name*
Phone Number*
Email*
Patient Intake Paperwork Completed?*

Session Information

Session Duration*
Would you like a break in the session?*
Break Length*
Type of Therapy*

Session Preferences

Which preference is most important to you?*
Which start times will work for you?*

We do our best to match your child with therapists they've worked with in the past but this is not guaranteed. If you're flexible or unsure on your child's therapy team, leave the section below blank and we will do our best to match your child with who we think they will work with best.

Therapist 1
Therapist 2
Therapist 3
Therapist 4
Would you like to stay at the NAPA apartment?*
Additional Requests