Schedule Now

If you are ready to schedule an evaluation, please fill out the following information. Our Practice Administrator will contact you within one business day and provide you with the Developmental History document and Consent Forms. If you have questions, please refer to the FAQ page on the website.

For questions related to the practice, the evaluation procedures, our policies, and additional information please see our FAQ page.

“If you are prepared to schedule an appointment, please complete the following steps and we will contact you to be placed on our calendar. For inquiries about current booking, please contact us”

STEP 1: Complete Patient & Parent Information

Square space demographics.

STEP 2: Review HIPAA Document & Sign Confidentiality & Practice Policy Documents

(include pdf of privacy practices HIPAA and Practice Policy Documents)

STEP 3: Complete & Return Developmental History Documents

a. Include pdf of developmental history.

b. Include a statement about joint custody – need other guardians to sign practice policies as well.

STEP 4: Send Prior Evaluations

A few sentences on what types we look at and how to get it to us.

Patient Information

First Name

Last Name

Date of Birth

Instructional Setting

Parent/Guardian Name

First Name

Last Name

Phone

Custodial Status

Evaluation Type

Payment Method

Preferred Provider

Any Prior School or Psychological Evaluations

Yes No

Primary Concerns

Schedule Now

STEP 1: Complete Patient & Parent Information

STEP 2: Review HIPAA Document & Sign Confidentiality & Practice Policy Documents

STEP 3: Complete & Return Developmental History Documents

STEP 4: Send Prior Evaluations

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