Become a Client

Do not use this form if this is an emergency. In the case of an emergency, call 911.

Please fill out the form below if you or someone you know is interested in becoming a client. Please allow 1-2 business days for responses. After initial contact, our staff will perform a quick evaluation (either on the phone or in person) and let you know about services and programs that may help you with your concerns. We look forward to meeting you.

If you are unable to fill out the form below, you may call us and leave a message at (310) 475-9620 ext. 1.

Please note that FACT may not be able to accommodate all requests for service, based on waiting lists, physical capacity, availability of staff or facilities, geographic limitations, funding status or other factors. If we are not able to provide services, we will make every attempt to provide you with referrals to viable alternative providers.

* These fields are required.

CAPTCHA image