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Application

Please see below for the forms you will need to get started. If you are applying for your child/adolescent, you will need the CHILD/ADOLESCENT Application. If you or your child are over 18, you will need the ADULT Application. Please email or fax the completed application to Dr. Chandler prior to your first appointment. 

CHILD or ADOLESCENT Application:

/userfiles/4938215/file/Letter, App, and Pay policy(2).pdf

ADULT Application:

/userfiles/4938215/file/Adult app(1).pdf

 

If your child has been evaluated by Dr. Chandler in the past and you are scheduled for a re-evaluation, please complete the following Modified Application Form. Only use this form if you have already been evaluated by Dr. Chandler. 

/userfiles/4938215/file/Modified Application.pdf

 

Additionally, to secure your appointment you will need to complete the Credit Card Authorization Form. Please click on the link below to secure your appointment if you have not done so already. Thank you.

 

https://form.jotform.com/213155584198160

 

 

Helpful Forms

Click here to view and print forms for your appointment.

CLICK HERE