Our Intake Form

Not many people enjoy filling out questionnaires, but for this process to be successful we need some background information about you and your

Parent / Legal Guardian Information
Treatment / Recovery Facility Information

Youth / Adolescent Information










Youth Transport Agent Instructions

Need to Download it?

You may also download a copy of our intake form to fill out and Fax it to
+1 888.244.5977

Connect With Us

Do you have a question for us? How about a comment about a recent experience with our services? No matter when and where you want to connect with us, we strive to deliver relevant information to you through our social media channels. We look forward to sharing and connecting with you.

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Our Office Locations

* Sherman Oaks, California 91403
* Union City, California 94587
* Eagle Mountain, Utah 84005
* Jacksonville, Florida 32210
* Now servicing the Greater Seattle,
Washington Area

Contact Information

Phone (Toll Free): +1 888.640.1844
Fax : +1 888.244.5977
Email : contact@YouthTransportLLC.com

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