Child & Adolescent Paperwork

This form is for Parents/Guardians to complete.

This form is for your child who is 14 and older. Do not complete if under 14 years old.

This form is for your child to look over (only for children 14 and older). This is a form about privacy and what we share with parents. Your child signs this. Do not give this to children who are younger than 14 years old.

Request for Therapy Session

I am interested in a therapy appointment with Christine Topping