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Making an Appointment

To contact us to set up an appointment, please fill out the form below. Asterisked items must be completed for the form to be processed. Unfortunately, we are not able to respond to requests for referrals to professionals in other areas, however there are a number of websites that you may find helpful including:

www.chadd.org
www.addresources.com
www.add.org
www.addvance.com

*Items in bold are required.

Consultation Request Form

Fill out the following information (* fields are mandatory) and click 'Submit'.

* First Name:
*Last Name
* Parent Name:
* Email Address:
* Home Phone:
Work Phone:
Comments & Feedback:

More Information on our Services

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