Medical Form

Thank you for your interest in the Teen Challenge program. Please print the medical form below and give to your doctor.

ripple in water

Contact us

888-339-3193
info@teenchallenge.net

390 MATHEW STREET
SANTA CLARA, CA 95050
UNITED STATES

other helpful numbers

Suicide Prevention Lifeline:
1-800-273-8255 | TTY: 1-800-799-4889

SAMHSA's National Helpline:
1-800-662-4357 | TTY: 1-800-487-4889

Disaster Distress Helpline:
1-800-985-5990 

Veteran's Crisis Line:
1-800-273-8255 | TTY: 1-800-799-4889

Domestic Violence Hotline:
1-800-799-7233 | TTY: 1-800-787-3224