CLP Intake Application Process
If you are interested in beginning an inquiry into how to move into NYEP, please get started by completing our Intake Packet.
Please do not feel intimidated by the amount of information that we are requesting. If you need immediate placement, please call (775) 240-2195. It is possible for NYEP staff to assist with completing the intake paperwork.
Please be mindful that we do not like to move new residents in on Fridays. We prefer Tuesday- Thursday move-ins, thereby assuring sufficient support if there are any transition issues within the first couple of days.
Please complete our Intake Packet:
Intake Application (printable version) – revised 5/16/2012
Resident/Client Medical Information Form
Resident/Client Medical Information Form (printable version) – revised 5/16/2012
Resident/Client Intake Requirements Checklist – revised 5/16/2012
Other Documents Required at Move In:
HIPPA Notice of Privacy Practices – revised 5/16/2012 (Axis I residents only)
HIPPA Notice of Privacy Practices Brochure Receipt – revised 5/16/2012
HIPPA Notice of Privacy Practices Complaint Form – revised 5/16/2012
Client/Resident Insurance Resources/Consent to Bill – revised 5/16/2012 (Axis I residents only)
Client/Resident Authorization for Release or Information – revised 5/16/2012
Client/Resident Social History Report Form – revised 5/16/2012
Intake Financial Overview Questionnaire – revised 5/16/2012
Client/Resident Lease – revised 5/16/2012
Medication Information Form – revised 5/16/2012
Medication Log – revised 5/16/2012
Medication Error/Incident Report – revised 5/16/2012
Other Helpful Links:
If you have any questions regarding our intake process, please contact us here. We look forward to meeting you and helping unprepared teens develop into self sufficient young adults!!