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Child Intake Packet
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I am looking forward to
working with you and your childr(ren). To aid my work with your
family I am asking you to fill out the following forms. Please
fill out the Child Intake Packet and Child Symptom Checklist for your child.
If your child is
struggling in school in any way I have included an additional packet to
be completed by your child's teacher which is called the Teacher
Packet.
If you have any concerns about your child's ability to
stay focused on tasks, control his/her impulses or control his/her
activity level, please fill out the ADHD Packet.
Thank you
for your willingness to give me this helpful information. Click
on the blue link that you desire and you will be able to download the
correct form which you can complete and bring to my office. To print the form once you are in Microsoft Word, after you click on the blue link, go up to the left hand corner of the screen, pull down the file menu and click on print.
Click here for Child and Adolescent Intake Packet (which includes Symptom Checklist)
Click here for Child and Adolescent Symptom Checklist
Click here for Teacher Packet
Click here for ADHD Packet
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