Thank you for your interest! Please fill out one of the following forms in as much detail as possible so that we will know how best to serve your needs. You will be contacted by the clinic coordinator after receipt of this form to discuss services, scheduling, and fees. Any questions about which form to fill out below can be directed to the Center for Clinical Services team at firstname.lastname@example.org.
- Center for Autism and Early Childhood Mental Health Interest Form (Prenatal to 12 years old)
- Community Counseling Clinic Interest Form (Adolescence 13 to 17 years old and Adults 18+)
- Psychoeducational Evaluation Interest Form (Children and Adults)
- Mind Crafters Interest Form (activity based counseling group for children ages 7 to 12 years old)