Contact Us
Please complete the following and someone will contact you as soon as possible. Also please fill the
Checklist for Kids
if for your child or
Checklist for Adults #1
&
#2
if for an adult. Thank you.
Contact Us
First Name
Last Name
Home Phone
Cell Phone
Email Address
Best time to contact:
Morning
Afternoon
Evening
How can we help you?:
How you heard about The ADHD Center: