Welcome

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. 

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

                                                                                                                      *Be sure to respond to ALL questions* 

Usually within a week of receiving the completed form, one of our staff members will contact you.