Welcome to Behavioral Pediatric & Family Therapy Program! 

We are a group of independent professionals providing psychological services to children, adolescents, and adults.  Our professionals have a wide range of expertise and areas of interest to help assist you and your family.

If you are interested in becoming a new patient, complete the following form to start the intake process.  Completing this form DOES NOT guarantee that you will be accepted as a patient in our clinic. It is simply the first step of the intake process. Be sure to respond to ALL questions. One of our staff members will contact you, usually within a week of receiving the completed form.

                   Initial Intake Form (CHILD PATIENT)     -OR-    Initial Intake Form (ADULT PATIENT)

Helpful Forms

Click here to view and print forms for your appointment.