Click to Download: Intake Form

Please be sure to check out the insurances we are currently accepting, If you have any questions please give us a call (702) 815-1550.

The following links help with filling out the form using Adobe Reader DC:

Click here for how to install Adobe Reader DC. (Download Adobe on Mobile or PC)

Click here for help filling out the form using Adobe.

SMH.SSH-Intake-12.12_21

Please email the form to the location you wish to seek services at:

Las Vegas: info@serenitymentalhealth.org