Intake Form

Get Started with our Intake Form

Download our intake form to start the process of creating a case with Adolescent Intervention Solutions.

AIS Intake Form (RTF Format)

Please fax or email the completed form to:

Fax: 240-213-0212
Attn: George Pineda

Once we receive the completed form an A.I.S. member will prepare and send your Transport Documents for your review and signing.
Please feel free to contact us by email or phone if you have any questions.

phone: 240-674-9961 direct