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LA COCINA GENERAL SERVICES INTEREST FORM

LA COCINA GENERAL SERVICES INTEREST FORM

Thank you for contacting us.  This form is for persons interested in La Cocina's therapy  and evaluation services, including for professionals and/or organizations who have a release authorizing them to make a referral for La Cocina's services.  Please complete the form and note we will respond to your request every Wednesday.  We proudly serve the state of Colorado.  If you have any questions or need assistance completing this form, don’t hesitate to call us at 970-232-0740.  We’re here to help and look forward to connecting with you.
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  • English (US)
  • Spanish (Latin America)
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    Please keep in mind any services you seek must include you, and you must be at least 12-years old to receive individual services at La Cocina. Due to privacy laws, La Cocina is unable to contact youths (ages 12-18 years old) or adult persons you may know but who have not completed this form this form for themselves. If you know a youth or adult who needs individual therapy, please share this link with them so they may complete the form for themselves.
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    If you or your family need immediate help, call 9-8-8. Remember that La Cocina does not respond to emergencies, and that it will take us 48-hours to get back to you!
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    Please note that La Cocina will not contact anyone who does not know they are being referred for services.
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    Please keep in mind that referrals for Latine persons usually result in better outcomes when the individual and/or family in need refers themselves. Whenever possible, we encourage you to help the individual/family who needs the services complete this form for themselves.
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    Please keep in mind that referrals for Latine persons usually result in better outcomes when the individual and/or family in need refers themselves. Whenever possible, we encourage you to help the individual/family who needs the services complete this form for themselves.
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    If you do not know the child or youth's exact age, please enter an estimate of their age.
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    La Cocina's newsletter is our primary form of communication with our stakeholders, and includes valuable updates and insights which may be of interest to you.
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