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2. Juvenile Intake Appointment Request

   Please use this form to make a request to schedule an intake appointment for juvenile cases only. 

4. Juvenile First and Last Name*
6. Parent First And Last Name*
8. Address*
10. City*
11. State*
12. Zip Code*
14. Juvenile Phone Number*
15. Juvenile Email Address*
17. Parent Phone Number*
18. Parent Email Address*
20. Do you or the parent or guardian need and interpreter?*

    1. Yes
    2. No
21. If an interpreter is needed, please select which language.
    -- Select One --SpanishVietnameseChinese (Mandarin)HindiArabicASLOther
22. If other, please identify which language.
24. Intake Appointment

    Prior to your hearing before the Judge, the Juvenile Case Coordinator will schedule an intake appointment with you and your parent or guardian. Please select which time of day works best for you and your parent or guardian so that the Juvenile Case Coordinator can assist in scheduling you for a time that works best for you. You may also select an in-person option, a virtual one where all parties are virtual, or a hybrid format where some are in-person and some are virtual. 

26. Please select the best time of day.*

    1. Morning
    2. Lunchtime
    3. Afternoon
27. Intake Appointment Type*

    1. In-person
    2. Virtual
    3. Hybrid
29. Virtual Meeting

    If attending a virtual hearing or meeting, a website link will be sent to you. You will need to have audio and video capabilities on your device. 
    Please test your device at https://zoom.us/test if you are unsure if you have these capabilities. 

31. Please provide any additional information or questions you may have.*
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field