PSYCHOLOGICAL EVALUATION

PSYCHOLOGICAL EVALUATION

APPOINTMENT REQUEST
Thank you for choosing Pam's Place for your mental health needs.

All clients need to be over the age of 18. If this invovles the therapist going to court or for medication review please stop and call the office. 313-894-8088.

Missed Appointment & Rescheduling Fee Policy:

Please be advised that missing two appointments will result in the forfeiture of your assessment fee. There are no exceptions to this policy. Our therapists have very full schedules, so please ensure you are available at the time you select for your assessment.

You can expect a follow-up email or phone call from your therapist. It is important to be available at your scheduled appointment time. If we can not reach you by phone an appointment email will be sent to you, so be sure to check your email daily.

If you miss your appointment without prior notice (no call/no show), a $65 rescheduling fee will apply.

For any changes to your schedule, please contact us as early as possible.

Thank you,
Mr. Edgar
RESCHEDULING POLICY
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
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Probation Officer/Lawyer/Job Name

First NameLast Name
P.O/ AGENT Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
P.O/ AGENT Email
example@example.com
Take a photo of your ID
Please provide three available dates and times below for your appointment, starting at least three days from today. You will receive an email or phone call confirming your appointment. Thank you!

.
Date

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Date
Hour MinutesAM/PM Option
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Date

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Date
Hour MinutesAM/PM Option
REASON FOR SERVICE

Payment Amount $310.00

USDPSY EVAL

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PSYCHOLOGICAL EVALUATION

Please provide three available dates and times below for your appointment, starting at least three days from today. You will receive an email or phone call confirming your appointment. Thank you!

Payment Amount $310.00*

Payment Methods

Payment Amount $310.00