Stage 1 - Secure Payment Form
Please complete your payment to begin Stage 1. Once payment is confirmed, you will be directed to a structured questionnaire that Dr Beth Eames will review carefully prior to your consultation appointment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
My Products
prev
next
( X )
Stage 1 - ADHD Online Pre-Assesment Questionaire
Questionaire to gather information prior to the in-person appointment
$
100.00
NZD
Submit
Should be Empty: