top of page
Home
About
Services
More
Use tab to navigate through the menu items.
Request An Appointment
First name
Last name
Email
List of all current medications (prescription and over-the-counter) including dosage and frequency
Briefly describe the main reason for the appointment. Include any specific symptoms or concerns.
By submitting this form, you acknowledge and agree to the following: Services Not Provided: I do not offer diagnostic testing for Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). No Stimulant Treatment for ADHD: I do not provide stimulant treatments such as Adderall, Ritalin, Vyvanse, Concerta, etc., for ADHD.
Submit
bottom of page