A Shift in Focus Therapy | SimplePractice

A Shift in Focus Therapy Send Message

Your info

First name

Last name

Phone

Date of birth

What state will you be physically located in at the time of service?

CT FL MA RI SC VA

Please see my website for details about evaluation services.

https://ashiftinfocus.org/adult-adhd-autism-evaluation

ADHD/ Autism Evals are self pay only. We do not bill insurance for evals. Therapy services may be billed to insurance, depending on your plan.

Reason for care

What kind of care is being sought?

Note: Evaluations are self pay only. Insurance WILL NOT BE BILLED. Ongoing therapy may be covered by your insurance, depending on your plan.

Adult Autism/ADHD Evaluation (self pay only) ADHD Evaluation (self pay only) Therapy for Adult with ADHD/Autism/AuDHD (based on availability)

I would prefer to get a response:

(choose all that apply)

By email By text By phone call

Administrative

Referral source

How did you hear about us?

Google Psychology Today Referred by my provider (doctor, etc) From a friend Other

Client Preferences

Is there anything else you'd like me to know at this stage?

Please keep this brief (1–2 sentences). This is not a space for detailed history or urgent concerns.

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.