Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to access the application form and open it in your preferred editor.
2. Begin by providing your personal details in Section 1, including your name, date of birth, age, social security number, and current address. Ensure all information is accurately filled out.
3. Continue to Section 2, where you will indicate your marital status and whether you are required to pay child support. If applicable, provide information regarding your children.
4. Move to Section 3, which focuses on your income history. Indicate any sources of income and the total monthly amount you receive.
5. In Section 4, outline your alcohol and drug abuse history by checking the substances you have used and providing the date of your last use.
6. Proceed to Section 5, which requires you to disclose any mental health history, including diagnoses, hospitalizations, and prescribed medications.
7. Complete Section 6 by providing details of any legal history, including arrests, convictions, and current legal requirements.
8. In Section 7, indicate your educational background, including the highest grade level completed and any degrees obtained.
9. Fill out Section 8 with your medical history, including details of your last physical examination, current medical care, and any medical conditions.
10. Finally, read through the information in Section 9, sign the application, and date it. Ensure you have reviewed all sections to confirm your understanding.
11. Once all sections are complete, save the document with your changes, and you may choose to download, print, or share the completed form as needed.

Take the next step towards support by completing the Atlanta Mission The Potter's House Intake Application online today.