All potential new clients (including those coming from referrals) need to fill out our intake/screen below to be considered for an evaluation. Please note that we have a waitlist at the moment, and it may take awhile for you to be seen, even for an evaluation. We will follow up with you within the week to complete the rest of our paperwork and get on the waitlist.
The buttons below will redirect you to a Google Form. You can NOT save and exit the form once you begin. The entire form should take 30-45 minutes to complete. Once this is completed, please add firstname.lastname@example.org and email@example.com to your email contacts so our follow up emails do not go to your spam.
For any additional questions, please visit our FAQ page, insurance page, or email our Administrative Assistant at firstname.lastname@example.org