Client Enrollment Form

Client Information

Guardian #1 Information

Guardian #2 Information

Insurance Information

Availability for Services

Please fill in the time blocks your child is available for direct services once registration has been completed (i.e., Monday 8:00am - 10:00am, Thursday 3:00pm - 5:00pm)

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Diversity - Our Roots and Our Legacy
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‍Diversity and inclusion is at the core of our history and identity. At Bridges Behavioral Therapy we want all of our employees to feel valued and free to be who they are. We aspire to cultivate an inclusive culture where all forms of diversity are recognized and appreciated by the company.
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Bridges Behavioral Therapy is committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion for both staff and patients.
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Our human capital is the most valuable asset we have. The collective sum of the individual differences, life experiences, knowledge, inventiveness, innovation, self-expression, unique capabilities and talent that our employees invest in their work represents a significant part of not only our culture, but our reputation and company’s achievement.
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We embrace and encourage our employees’ and clients’ differences in age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees and clients unique.

Bridges Behavioral Therapy’s diversity initiatives are applicable—but not limited—to our practices and policies on recruitment and selection; compensation and benefits; professional development and training; promotions; transfers; social and recreational programs; layoffs; terminations; and the ongoing development of a work environment built on the premise of gender and diversity equity that encourages and enforces:
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- Respectful communication and cooperation between all employees.
- Teamwork and employee participation, permitting the representation of all groups and employee perspectives.
- Work/life balance through flexible work schedules, vacation/sick time to accommodate employees’ varying needs.
- Employer and employee contributions to the communities we serve to promote a greater understanding and respect for diversity.
- As our company continues to grow, we plan to ensure we are representing all ages, races and body types in company training materials and web pages.
©2022 Bridges Behavioral Therapy.