For appointments/inquiries: (214) 755-6119

Therapy Dallas specializes in individual and family-based treatment for children, adolescents, and adults.

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Inquire/Register – ADHD Parent Group

Interested in joining this group and/or learning more?

Please complete the below information and we will reach out to you shortly.

Parent/Guardian's Full Name

Phone

E-mail

State of Residence

Preferred Method of Contact

Phone E-mail No Preference

Child's Full Name

Age

School

Grade

Current school accommodations (if any)

Has your child been formally diagnosed with ADHD?

Yes No Awaiting evaluation results

If yes, what ADHD diagnosis?

Predominantly Inattentive Presentation Predominantly Hyperactive-Impulsive Presentation Combined Presentation Unsure

If yes, who diagnosed your child?

Date of Diagnosis (month/year or "N/A")

Provider type:

Psychologist/Evaluator Pediatrician Psychiatrist Other Not Applicable

Please list any additional mental health concerns, suspected and/or diagnosed (e.g., anxiety; depression; learning differences; etc.):

Have you previously sought Parent Consultation for ADHD?

Yes No

Is your child currently taking psychiatric medication intended to manage his/her ADHD symptoms?

Yes No

Is your child currently in individual therapy?

Yes No

If so, are you comfortable sharing with your child's therapist the fact that you may participate in this therapy group?

Yes No Not applicable

What would you hope to get out of this group?

What questions do you have about this group (if any)?

Do you have a preference for how we meet?

In-person Virtually I'm flexible

Is there any additional information you'd like to share with us?

I learned of this group from:

Professional School Family/Friend Internet Other

Contact Us

Therapy Dallas
12800 Hillcrest Rd A124, Dallas, TX 75230
214-755-6119 (office) • 214-481-2851 (fax)

Want to learn more?

Our therapists enjoy presenting on topics
related to child/adolescent development
and mental health, and welcome interested
parents, caregivers, educators, and/or
professionals to attend upcoming presentations.

Click the Share tab for upcoming events!

Join our Presentations Mailing List

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and resources available through our practice?
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of your choosing.

Inquire/Register – ADHD Parent Group

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