Documents and Resources

For New Patients

We require the following forms completed in order to evaluate your child, as well as a referral from your child's physician.



Please print, complete and return to us via fax or mail:

26420 Kensington Place, Suite C | Daphne, AL 36526
Office: 251.517.0355
Fax: 251-625-1969

Please Contact Us to request the following forms:

  • Authorization of Release of information
  • Dyslexia Symtoms 1-Page Checklist