We would like to inform you that you that you have been referred to our clinic for a COMPULSORY PSYCHOLOGICAL EVALUATION ONLY scheduled by a third party. This differs from other visits you may have because this is a COMPULSORY PSYCHOLOGICAL EVALUATION, and is usually accomplished in only one visit to include an initial interview with the psychologist. Following this initial interview, psychological testing will be administered either remotely or in the office.
What you will experience today: The psychologist will listen to you carefully. She will take a detailed history. Psychological testing will be performed. However, because this evaluation was arranged by a third party, she will not be able to provide you with a diagnosis, treatment recommendations, or any other information regarding your psychological treatment or condition.
Also, because this evaluation was arranged by a third party, she will not be providing you with a copy of your results of your evaluation and/or any testing performed as part of your evaluation. Results and evaluations are sent to the third party requesting the compulsory psychological evaluation. Please contact the third party that scheduled your appointment with us if you have any questions regarding requesting a copy of any information obtained from this evaluation, or if you have any other questions regarding the evaluation.
I have read and understand the above information, and I UNDERSTAND THAT THE PSYCHOLOGIST, DR. SHELLEY TINDELL, PSY.D., THAT IS PERFORMING MY COMPULSORY PSYCHOLOGICAL EVALUATION IS NOT MY TREATING PSYCHOLOGIST.
I UNDERSTAND THAT I MUST THEREFORE SEEK TREATMENT OR CONTINUE TREATMENT AT ANOTHER FACILITY FROM ANOTHER PSYCHOLOGIST OF MY CHOICE, FOR ANY AND ALL PSYCHOLOGICAL NEEDS I MAY HAVE.