L.A. CADA

Select services to be purchased

Quantity	Description	Cost
	Anger Management - Enrollment	25.00
	Anger Management - Session	15.00
	Domestic Violence Batterers Intervention - Enrollment	35.00
	Domestic Violence Batterers Intervention - Session	25.00
	Domestic Violence Victims - Enrollment	25.00
	Domestic Violence Victims - Session	15.00
	Drug Counseling (11550c) - Enrollment	35.00
	Drug Counseling (11550c) - Session	25.00
	Drug Diversion (PC100, DEJ: Deferred Entry of Judgement) - Enrollment	35.00
	Drug Diversion (PC100, DEJ: Deferred Entry of Judgement) - Session	25.00
	Drug Education - Enrollment	25.00
	Drug Education - Session	15.00
	Outpatient - Assessment and Intake	60.00
	Outpatient - Therapy Session	60.00
	Outpatient - SUD Counseling	30.00
	Outpatient - Session	15.00
	Parenting and 52 Week Parenting - Enrollment	25.00
	Parenting and 52 Week Parenting - Session	15.00
	Medical Peer Support Specialist Training Program	1600.00

Service Location*

Downtown LA

Long Beach

Santa Fe Springs

Participant's Information

First name*

Last name*

Email*

Phone number*

Street*

Apt/Ste/Unit/etc.

City*

State*

Zip*