NOTE: This form is intended for those seeking specific Psychological Assessment/Testing Services. If you are wanting to request an appointment for counseling services with CIFT, please click here to request an appointment with one of our therapists.
NOTE: If you are under the age of 18, please have a parent or guardian complete the form and submit it for you. Client Name: (required) Parent, guardian, caregiver name (or N/A if adult); church/pastor (if for a clergy assessment); foster/adoption agency (if for a pre-adoption parent evaluation): (required) Phone Number: (required) If appointment is for a minor, please provide parent or guardian phone number. Email: (required) If appointment is for a minor, please provide parent or guardian email. Client Age (required): Client Date of Birth (MM/DD/YY) (required):
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We have five different locations in Southern California to serve you. Click on the photos below for more info about any of our offices.