When submitting the form, please provide as much information as possible. This information is kept private and not shared with anyone outside of our agency.
After submitting the form, our Intake Specialist will contact you within two business days to schedule your first appointment.
If you are having difficulty completing this form, please call our Intake line at 302-478-9411 ext. 306. (Please have your insurance information readily available.)
If you are experiencing an emergency, call 9-1-1 or go to your nearest emergency room.
JFS is NOT a crisis center or a residential treatment facility.
Once you press submit, please check your email inbox for a confirmation message that your submission was received. If you don’t see the message, please check your spam folder or email firstname.lastname@example.org
Our Intake Specialist will be in touch within 2 business days to schedule your appointment.