Intake Application

Intake Applications

Please fill out the below applications online, or print them to bring to our office. 

Online Forms

Address

752 US Highway 27 North
Avon Park, FL 33825

Phone

Office: 863-453-8901
Cell: 863-253-9672
Fax: 863-453-8903

Email

Service Areas Covered

Hardee, Highlands, Desoto, Glades, Hendry, Okeechobee Counties