Thank you for your interest in our services! Clients are accepted by application only. To fill out an application, please follow the steps listed below:
To apply for our services:
- Download and fill out an application based on the service(s) you are interested in. (See links below)
- or click here to apply online. For online youth applications, a teacher report form is required.
- Drop off, fax in, or mail in your application to our address:
Community Clinic, ED2-155
1250 Bellflower Blvd,
Long Beach CA, 90840
- Once received, Clinic staff will call to notify you that your application was received
- Clinic faculty will assess the information you provided to determine whether the criteria for the services offered are met.
- You will be contacted a second time, after the revision process is complete, to inform you of the status of your application.
- If you are confirmed for our services or placed on the wait-list, our Clinic staff will remain in contact with you to answer any of your questions and to provide you with parking, receive payment, and further instructions.
- If you need any assistance, please feel free to call the Clinic office at (562) 985-4991.
- Admittance is based on a first-come, first-served basis and on the level of need.
- To maintain your confidentiality, we suggest you mail or deliver the application in person, rather than sending it via e-mail.
- Depending on the services requested and the date your application was received, there may be a waiting period.
- The primary purpose of the Clinic is to provide a training site for graduate students enrolled in various practicum courses. Although we would like to assist everyone who requests our services, we are not always able to do so.
- In the case of a minor, only a parent or legal guardian of the child may submit an application for services.
- If you would like to apply for a scholarship, please see our fee reduction guidelines:
For Academic Interventions (ages 6-17), Psychoeducational Assessment (ages 6-17), or Youth Counseling (ages 17 and under):
Youth Application (PDF)
Teacher Report Form (ages 6-17), Required for all Online Applications
Teacher Report Form (PDF)
For the Early Childhood Assessment Clinic (ages 3-6):
Early Childhood Assessment Application (PDF)
For the Transition Planning Clinic (ages16-22):
Transition Planning Application (PDF)
Once a complete application is received and found appropriate for Clinic services, you will be contacted by a student assistant who will confirm your appointment and arrange your parking.
Aplicaciones en Español:
Para Tutoriá (edades 6-16), Evaluación Psicológicas (edades 6-16), o Consejería de Juventud (edades 17 y bajo):
Aplicacion de Jovenes (PDF)
Para Consejería de Adultos, Familiares, Individuales o de Parejas (todas edades):
Consejeria para Adultos (PDF)