This longer form helps determine whether your concerns fit within Dr. Steen's scope of practice (licensed psychologist, AASECT-certified) and is appropriate for your needs. Please look for an email with the full questionnaire after submitting this form. Your appointment request cannot be reviewed until that questionnaire is completed. Do you consent to Dr. Steen reviewing this information and contacting you about potential services?
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.