You Grow Girl! | SimplePractice

Demographics

Step 1 of 5 1 of 5 steps

Your info

First name

Last name

Phone

Name you go by

Date of birth

Gender

Does the individual seeking services reside OR attend school within a 10-mile radius of You Grow Girl! zip codes 98144 (Seattle) OR 98444 (Tacoma)

We do not accept referrals for individuals outside of the 10-mile radius service area; unless the individual is unhoused/homeless and is willing to be served at one of our physical locations

Age

We do not accept referrals for individuals outside of the age range

Legal Guardian Full Name (required if under 13)

Write N/A if Self-Referral, Over 13

Relationship

Legal Guardian Phone Number

Write N/A if Self-Referral, Over 13

School Name

Grade

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.