Assessment Contact

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Please note that our waitlist is currently full, and we will not be accepting new clients for assessment until the current waitlist is complete. We will update this page when appointments for assessment are open. We recommend checking back in the summer of 2022. Thank you!

Assessment information form

I understand that this form is only to be used for requests for Psychological or Educational Testing, and that WellSpring will be unable to respond to requests for therapy appointments or other services. I understand that under no circumstances should this form be used in emergency situations, as it is not a reliable avenue for help. If this is an emergency, please dial 911 or go to your local emergency room. Thank you. *

I acknowledge that I have read an understand the above statement

* Indicates required field

Name *

First

Last

Phone Number *

Email *

This assessment is for: *

Myself My Child Other

I am seeking a: *

Psychological Assessment (e.g., ADHD, Autism, Mood or Anxiety Disorder, Behavioral Disorder, etc.) Educational Assessment Other

I have the following insurance: *

Anthem/BCBS/FEP CareFirst Tricare Medicare Other: My insurance is not in-network; I plan to self-pay for services

Comment *

Thank you! We look forward to speaking with you soon.

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