Application for Services

Please print out the application for services form from here. Fill in and return to me (by email or by surface mail) prior to the first consultation. 

Other handouts such as the schedule of fees and privacy policy are available here.

No fees are associated with an initial application for services. 

An application for services does not obligate you to continue with services.

Note: Copies of relevant forms and information will be provided to you at the time of consultation. Once you have read the privacy policy, and have agreed to the terms of service, a contract will be written for the provision of applied behavioural or psychological services for your child.

Request a Brochure or Application Form