client Intake Forms:

*All forms MUST be filled out AFTER making an appointment or scheduling group, whether in person or online. Please call the office at (702)-258-5855 to make an appointment.  (Please send new client referrals to lsuyat@factsnv.org) 

Fill-out the appropriate forms prior to the appointment. Click on the intake form link and download the form to your device. Open the downloaded form and enter your information. When finished, save the completed form again to ensure your data is kept. 

You can submit your form back to us by one of the following methods:
1) Attach the saved document to your e-mail, In subject write Attn: Last Name, Appointment Date/Time and send to lsuyat@factsnv.org

OR
2) Print and mail to: Family and Child Treatment of Southern Nevada

 8080 W. Sahara Avenue Suite D. Las Vegas NV, 89117

OR
3) Print the completed forms and submit them to the front office on the day of your first visit, at least 15 minutes prior to your appointment. 

If you do not have access to a printer, we are happy to provide the forms prior to your appointment at the clinic.

We created our forms with Adobe Acrobat. Below are free Adobe downloads to help access these documents.  

Adobe Acrobat Reader Computer 

Adobe Acrobat Reader Iphone  

Adobe Acrobat Reader Android