top of page
Minor Consent Form
STEP 1
Fill Out Form
Please fill out the form below to the best of your abilities.
You can either:
a. Fill out electronically and download
b. Fill out electronically and print it
c. Print and use pen to fill out
STEP 2
Return Completed
When you've filled out the form:
-
Download the file to your computer with your inputs (⤓ icon)
-
Send the completed form as an email attachment to hello@AffirmativeCounselingCenter.org
-
When sent, delete the email from your sent folder for added security
* If printed or filled out by hand, please return it in person or by mail to 5919 W 3rd St, Ste 1E, Los Angeles, CA 90036.
Please fill out the form on a laptop or desktop. Not compatible on mobile, or in Apple Preview. Thank you for your understanding!
bottom of page