This form is for caregivers requesting non-clinical support and guidance.
Please do not include medical records or sensitive health information. If this is an emergency, call 911. For immediate mental health support, call or text 988.
I understand that Landon's Place is not an emergency service. If I'm in crisis or someone is in immediate danger, I will call 911. If I or someone I know needs immediate mental support, I can call/text 988.
Please do not include medical records or sensitive health information in this form.
I give Landon's Place permission to contact me using the information I provided.