Anger Management

Referral Instructions

Please complete the referral form below to enroll in the Anger Management Program. This eight-week, evidence informed course is designed for individuals seeking to understand and manage anger in constructive and healthy ways.

The program provides education, discussion, and guided practice to help participants identify triggers, control emotional and physical responses, and prevent anger from escalating into harmful behavior. Participants learn practical tools including self-monitoring, relaxation strategies, and communication skills to foster accountability, emotional awareness, and positive decision-making.

Once the referral form is submitted, our team will review the information and contact the participant to discuss scheduling, enrollment, and payment details unless otherwise noted in the additional notes section. If you have questions or need assistance completing the form, please contact our office for support.

Please include any court orders, probation requirements, or special considerations in the additional notes section to help us coordinate services effectively.

Anger Management

This field is for validation purposes and should be left unchanged.

Personal Information

Full Name(Required)
MM slash DD slash YYYY
Your Email Address(Required)
Address(Required)
When is the best time for us to reach you via telephone?

Case Manager Information (If Applicable)

Full Name
Case Professional Email Address

Service Information

How did you hear about us?(Required)

Consent + Agreement

I hereby confirm that the information provided above is true and accurate. By typing my name below, I acknowledge that it serves as my electronic signature.
Consent(Required)
MM slash DD slash YYYY