By submitting this form, I consent to the collection and processing of the information provided above by Warriors First Inc. I understand that this information will be used for the purpose of providing me with requested services and may be shared with relevant parties involved in my care.

I acknowledge that I have read and understood the terms of service and privacy policy of Warriors First Inc.

I understand that I have the right to withdraw this consent at any time by contacting Warriors First Inc. However, withdrawal of consent may affect the provision of services.