Intake

Our intake process is thoughtfully designed to understand your unique story, current challenges, and personal goals for mental health and wellness. This helps us match you with the right counselor, therapist, or program — whether you're seeking individual therapy, women’s mental health support, adolescent services, medication management, or ORP overdose prevention training in Kent County.

Once you submit your secure intake form, our compassionate team reviews your information and contacts you promptly to schedule your first appointment. We are committed to making this process smooth, respectful, and stress-free.

Get Started

Fill out the intake form below to begin your journey with Light of Life Recovery and Wellness Services. We are here to support you every step of the way.

Full Legal Name *

Date of Birth *

Assigned Sex at Birth *

Male
Female

Preferred Pronouns *

She/Her/Hers
He/Him/His
They/Them/Theirs
Other

Ethnicity *

Not Hispanic or Latino
Hispanic or Latino

Phone Number *

Email address *

Known Medical Conditions *

Previous Therapy/ Counseling Experience *

Yes
No

Current Mental Health Concerns *

Goals for Therapy *

Additional Thoughts/Concerns *

Start Your Journey to Wellness Today

Take the first step towards a healthier, more fulfilling life by filling out our intake form.