In order to obtain services at the Child Study Study, you will need to complete an application for services. The entire application must be completed, including the entire Guarantorship and Insurance Information Forms, and all requested information must be included. If the child is school aged, the child's teacher will also need to complete the school forms. Please be aware that your application will not be processed and no appointments will be made until all the paperwork has been received, including the school forms (keep this in mind as summer vacation from school approaches). Once all the paperwork is received, our triage committee will review your child's application to determine which clinician will best suit the needs of your child based upon the information in the application. The Client Services Department will then verify insurance coverage, if applicable. If insurance is involved, no appointments will be made until any insurance requirement for referral/authorization has been satisfied. Client Services will then contact you to schedule the appointment and talk with you regarding insurance or any financial concerns you may have. They will attempt to call you several times to schedule the appointment. If they are unable to contact you, a letter will be sent to you stating that they are ready to schedule an appointment.

Click here to download CSC Application Form

The application file is in Adobe Acrobat (PDF) format. If you do not have Acrobat Reader already installed on your computer, click here to download and install the free plugin.