Forms_files/RELEASE%20OF%20INFORMATION.pdf
  1. Forms

  1. Form for the first appointment

Many parents find that completing the CHILD HISTORY FORM from home is convenient so that records, baby books, report cards, etc. can be referenced.  This form requires information about your child’s early development and school history and can be accessed by clicking the link below.    Please print and complete the CHILD HISTORY FORM and bring it to the intake appointment.  

CHILD HISTORY FORM.pdf
Forms_files/Child%20History%20Form.pdfForms_files/Child%20History%20Form_1.pdfshapeimage_4_link_0
  1. Other forms

If we have completed an evaluation of your child and you would like us to speak with another provider, please call or email us with your request.  Additionally, please fill out, sign, and fax the RELEASE OF INFORMATION form acknowledging that we have your permission to discuss results and recommendations with the person you designate.  Feel free to call or email us if you have any questions about the form.

RELEASE OF INFORMATION.pdfForms_files/RELEASE%20OF%20INFORMATION_1.pdfForms_files/RELEASE%20OF%20INFORMATION_2.pdfshapeimage_5_link_0

12381 Wilshire Boulevard, Suite 101  Los Angeles, CA 90025

Phone: (310) 387-2888    Fax: (310) 820-7970 

  Email: DrKawa@ChildPsychTesting.com

Copyright 2010 by Allison Kawa, Psy.D.

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  1. allison kawa, psy.d. & associates,

  2. a psychological corporation