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Contact Form and Disorders' Checklists

The best way for us to start helping you is for you to fill in our Contact Form and Symptom Checklist. There are different types depending on the type of disorder you are contacting us about. This step is very important, as it gives us the information we need to determine if we can help you or not. Upon filling out the form, you will be contacted by one of our professionals within 24 hours.

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Child with Attentional Deficit Disorder / Attention Deficit Hyperactive Disorder
Fill in this form if your child may have an attentional disorder.

Child with Autism or Asperger's Disorder
Parents fill in this form if your child has Autism or Asperger's Disorder.

Adult with Attentional Deficit Disorder
Adults who may have a attentional disorder fill in this form.

Child with a ADHD and a Language or Learning Disorder
If you believe your child has a ADHD and a Language or Learning Disorder please fill in this form.

Adults coping with stress or a stress related disorder or disease.
Please fill in this form if you are experiencing high levels of stress or a stress related disorder or disease.