Schedule Orientation

This field is hidden when viewing the form

url_ClientID

This field is hidden when viewing the form

Client ID

Select Client

Select a client from the list below. If the client doesn't exist, you can create one now.

To be engaged in our services all clients get started by registering to attend our orientation session that we have in-person every other week. During the orientation you will meet with a case manager to talk about the services that you qualify for.

Select Upcoming Orientation Session(Required)

If you can't find a date that works well for you, you can contact our team by calling 317-612-6800.

This field is hidden when viewing the form

Session Label

This field is hidden when viewing the form

Date of Orientation

This field is hidden when viewing the form

Registered by

This field is hidden when viewing the form

Date of Registration(Required)

This field is hidden when viewing the form

Registration Source

Registration Details

This field is hidden when viewing the form

Date of Birth

This field is hidden when viewing the form

Age

This field is hidden when viewing the form

Triage Staff

This field is hidden when viewing the form

Case Manager