This form is used to collect basic, important information. Please fill out this form in its entirety and please do not leave anything blank. All information will be used to better assist you as you complete programs through Good Men Health. All information provided is confidential.

This document contains important information about services and business policies. Please read this document carefully before initialing, signing and submitting. If there are any questions, please email us.

This form is used to identify which program potential clients should be placed in based on the professional opinion of a professional and/or legal organization. Please complete this form and submit it to us. Please include referral source’s contact information.