SEEDS Therapy Center
Program Inquiry Form

Please fill out the following form to schedule a 30-minute screening to determine  eligibility for STC services. Please note: this form is not a guarantee of service. 

Potential Client Information 

Living Environment:
Is the individual Conserved?

Funding Source 

Are you a client of SDRC?

Parent/ Guardian/ Conservator Information 

Preferred Method of Contact:
Best Time to Contact:

Thanks for submitting! We will be in contact with you soon!