Consultation Services- Client Information Form
Please complete the following form if you would like to be added to our waiting list for consultation services. These are typically provided to adults with developmental disabilities who may not have an option for direct therapy services. We will contact you as soon as we have an opening that aligns with your child's availability. We encourage you to contact other providers in the case they may be able to begin treatment sooner.
I would like to receive emails from Trusty Behavioral Services including newsletters and useful information. I understand my email will not be shared with any third-parties.
Name of Person Completing Form
What is your relationship to service recipient?
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This form was created inside of Trusty Behavioral Services, LLC.