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Beacon Psychology Services LLC; 11495 N. Pennsylvania, Suite 105; Carmel, IN 46032
(317) 942-4020
© 2017 Beacon Psychology Services LLC
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Please print out and complete these two forms for your child's first appointment:
Youth Background Information
Youth Registration
Teacher Information Form
(not needed for your initial appointment)
If there are school-based issues, please print out this form and have your child's teacher complete:
This form gives your consent for us to communicate with specific agencies/individuals regarding our services to you:
Release of Information
(not needed for your initial appointment)
General Information:
Privacy Polices
Beacon Psychology Services
"Lighting the Path to Full Potential"
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