Admissions - We Treat Struggling Young Adults On and Off the Spectrum

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Application Instructions:

Thank you for your interest in New Directions and our customized services.

Prior to setting up an interview and personal meeting with our staff, we ask that you complete our online application (located on the bottom of this page) and attend our program tour. Once submitted, our Director of Admissions will then call you within 24 business hours to schedule your program tour and appointment.

Typically, students and parents/guardians will attend the intake appointment together; however, this is not mandatory. Our clinical staff will review your application along with any educational evaluations and/or psychological evaluations that you provide. These should be emailed to [email protected] or faxed to (954) 571-5265 before your tour date for our review.

During your initial meeting, we will discuss our service recommendations and associated costs. You will also receive a tour of the apartment complex and the residences where our students reside.

We look forward to meeting with you. If you have any questions about the application process, you can call (954) 777-3377 or our main office number (844) 814-7084.

Application Steps:

Please the demographic information request below and pay the $75 application fee.

Once received, our Admissions Director will call you within 24-business hours to help schedule your program tour.

You will also immediately receive an automated email response which will instruct you where to send previous IEPs, educational, psychological/ psychiatric evaluations for our clinical team to review.

You will also receive (within 24 hours) a link from “Ping MD” to your email. This will allow you to complete the remainder of our online application.

*Please note that our application is several pages and can comfortably be completed at your leisure before you attend your program tour. This information is often helpful for our professional staff in working to customize the individual service plan (ISP). Please note that all information in the electronic database is kept confidential.

Parent/Guardian Information:
Parent/Guardian Name:*
First Last
Parent or Guardian*
- Parent
- Guardian
Additional Parent/Guardian
First Last
Parent/Guardian Email:*
Parent/Guardian Phone:*
Student Information:
Student Name:*
First Last
Student Phone*
Student Email*
Social Security Number (SSN)
enter numbers only - do not include dashes
Student Birthdate*
Additional Information:
Will you be using insurance coverage to you cover the cost of clinical services?
- Yes
- No
Insurance Company
Subscriber Name
First Last
Policy Number
Subscriber Relationship
Does the student plan on attending in the next 3 months?*
Have they graduated high school?*
If yes, have you attended any college classes?
Do they want to attend college?
Does the student have a vocational path of interest?*
If yes, what field of study?
Is student interested in participating in a professional vocational internship?
Name of Primary Psychiatrist
First Last
Primary Psychiatrist Phone Number
Primary Psychiatrist Email
Name of Primary Therapist
First Last
Primary Therapist Phone Number
Primary Therapist Email
Location*
How did you hear about New Directions?*
Referring Person or Agency
Other
Will the student want to live in a shared apartment with their own bedroom and bathroom?
Will the student require a supervised house?
Will the student prefer to live in their own apartment?
Will the student require assistance in managing their medication?
Will the student require assistance with transportation?
Does the student have a drivers license?
Does student have their own car?
Payment Information:
California Fee Code

*Note - leave this field blank unless you are a California Regional Center Client and have been given a code by one of our New Directions staff members.
Product Name
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your young adult struggling with the responsibilities of independent living?

At New Directions for Young Adults, we can help!

Apply to NDFYA

Parent/Guardian Information:

Student Information:

Additional Information:

Payment Information:

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