Welcome to TLC Scheduling!
Help us understand what your scheduling needs are using this form. We do all BIG scheduling changes forms similar to this one.

Trust us when we say that we have tried sticky notes, paper forms, notes on napkins from husbands or nannies, phone calls to different people answering... even telepathic messages!

If the forms leave any questions out or you need to contact scheduling - please send us an email to

We look forward to serving your family in the best way we can!

Email address
Do you have an estimated date of when you would like to start working with us?
Your answer
Format for scheduling requests:
N/A (Not Available/Not possible)
1.5 x 3 days (1.5 hours x 3 days/week)
M/T/W/Th/F (days of week)
3:30-7:00pm (range of availability)
What days and times do you prefer?
Your answer
If your first preference is not possible, what days/times might also be possible?
Your answer
What days/times are NOT possible at all?
Your answer
Clinical Needs
Your availability and clinician availability are BOTH involved in creating a successful schedule. Your answer to the following questions will help us create the best clinical match for your child.
Describe the type of clinician that you believe your child will best respond to:
Your answer
What else should we consider when assigning a primary clinician to your child's therapy?
Your answer
Is there anything else you would like to tell us?
Your answer
Thank you! We look forward to seeing your child succeed!
A copy of your responses will be emailed to the address you provided.
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