Forms & Enrollment
Start Your Perfect Start With the Right Form
To help you begin services smoothly, A Perfect Start offers simple, accessible forms for referrals and client enrollment. Whether you're a potential client, a family member, or a professional making a referral, the forms below will help us get to know you and begin the intake process quickly.
Please choose the form that best fits your needs. All submissions are reviewed within 24–48 hours, and our intake team will reach out with next steps.
Referral Form
For: Providers, case managers, therapists, hospitals, and community partners.
Use this form to refer an individual who may benefit from PRP services.
This form includes identifying information, clinical details, diagnoses, psychosocial needs, and provider contact information.
Client Demographic Form
For: Individuals enrolling in services or families completing intake on behalf of a youth.
This form provides essential demographic, medical, and mental health history information needed to set up your profile and begin services.
How to Submit Your Forms
Once completed, please email your forms to:
📧 info@APerfectStart.site
Or bring them directly to our office during business hours.
Need Help?
Our team is here to guide you. If you're unsure which form to complete or need assistance filling it out, contact us at:
Phone
410-365-4117
info@aperfectstart.site