Clone of SCREENING NEW TESTING CLIENT FORM

1

Due to high demand, there can be a delay of a few weeks for a testing appointment. Before completing this request for services, please acknowledge that you understand and accept this timing.* This field is required.Select Yes to continue and No to exit.

YESNO

2

Are You the Client and Are You Age 18 or Older?* This field is required.

YESNO

3

Are You the Parent or the Legal Guardian of the Client?* This field is required.

YESNO

4

Is the Client Able to Complete Testing in English?* This field is required.

YESNO

5

We apologize that we are not able to schedule testing soon enough to meet your needs at this time. We are working to shorten the timeframe for appointments so please check back with us later.

6

We apologize that we are not able to schedule testing for you at this point. Clients must be 18 years of age or older or the person completing this form must be the client's parent or legal guardian. Please contact us via chat at our website if you have questions. Thanks for your interest in Genesis Counseling Center and we hope we can serve you soon.

7

Psychological testing services are currently available in English only, although we expect to add Spanish-language testing services soon.