Platte Psychological Services LLC

Platte Psychological Services LLC Send Message

Who would be receiving care?

Someone else

Your info

First name

Last name

Phone

Name you go by

Date of birth

Gender

State

Select the state you live in

Reason for care

What type of psychological evaluation are you seeking?

ADHD Autism spectrum disorder Mood and anxiety disorder Trauma-related evaluations Personality assessments Cognitive and intellectual testing Learning disorder evaluations Other

Who is the evaluation for?

Myself My child or adolescent Another adult for whom I have legal authority to request services Someone else

If the evaluation is for a child or adolescent, what is the child’s age?

Are you the legal parent or guardian of the minor for whom services are requested?

Yes No Not applicable

Is this evaluation being requested for any legal, court-related, custody, immigration, disability, employment, or forensic purpose?

Platte Psychological Services does not provide custody evaluations, parenting capacity evaluations, or forensic evaluations unless explicitly agreed to in writing before services begin.

Yes No Not sure

Billing & Payment

Payment method

Platte Psychological Services is a private-pay practice and does not bill insurance directly. Are you comfortable with private-pay fees for psychological evaluation services?

Yes I would like more information

Client Preferences

Preferred appointment times

Morning Afternoon Evening Weekend

Is there anything that the practitioner needs to know?

Limited to 600 characters

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.