Resources and Forms

Forms

New Patient Paperwork

Please download, print and complete the following forms, then bring them to your first appointment:

Intake-Questionnaire

HIPAA-Privacy-Notice

Receipt-of-Privacy-Practices

Informed-Consent

Payment-Authorization

Child Testing Forms

Please download, print and complete the following forms, then bring them to your first appointment:

Developmental-Questionnaire-1

Anxiety Clinic Forms

Please download, print and complete the following forms, then bring them to your first appointment:

Developmental-Questionnaire

Adolescent-Anxiety-Clinic-Card-on-File-Form

Working With Other Professionals

Please download, print and complete the following forms, then bring them to your first appointment:

Primary-Care

Authorization-of-Release

Mental Health Links

https://www.adaa.org/ (Anxiety and Depression Association of America )

www.nami.org (National Alliance on Mental Illness)

teenmentalhealth.org

Addictions

Addiction Center

Addiction Center is a comprehensive addiction information hub providing a definitive guide to the dangers of abusing alcohol, illicit drugs, prescription drugs and more. They review top treatment centers to help you find the one that gives you or your loved one the best chance for recovery.

Alcoholics Anonymous

Alcoholics Anonymous® is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

Alcoholics Anonymous Family Groups

Friends and families of problem drinkers find understanding and support at Al-Anon meetings.

American Lung Association-Fighting for Air

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through Education, Advocacy and Research. With the generous support of the public, we are “Fighting for Air.” When you join the American Lung Association in the fight for healthy lungs and healthy air, you help save lives today and keep America healthy tomorrow.

Substance Abuse and Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Anxiety & Stress/PTSD

Anxiety & Stress/PTSD

Anxiety Disorders Association of America
The Anxiety Disorders Association of America (ADAA) is a national nonprofit organization dedicated to the prevention, treatment, and cure of anxiety disorders and to improving the lives of all people who suffer from them.

The Coming Home Project

The Coming Home Project is a non-profit organization devoted, since 2006, to providing expert, compassionate care, support, education, and stress management tools for Iraq and Afghanistan veterans, service members, their families, and their service providers. We are an experienced team of psychotherapists, veterans and interfaith leaders committed to alleviating the unseen wounds of war.

National Center for PTSD

The Center aims to help U.S. Veterans and others through research, education, and training on trauma and PTSD.

Children

Adoption Information Center of Illinois

Adoption Information Center Of Illinois provides resources so families can meet children waiting to be adopted, caseworkers can register waiting children and families with our Adoption Listing Service, and everyone can find a way to help the 15,000+ young people currently in foster care in Illinois.

Allendale Association

Founded in 1897, The Allendale Association is a nonprofit child welfare agency dedicated to excellence and innovation in care, education, treatment and advocacy for troubled youth and their families. Since 1897, The Allendale Association has been serving the children and families of Illinois and southern Wisconsin. Over the years, Allendale has evolved into a residential, educational and counseling organization for boys and girls ages 8-18 suffering emotional and behavioral disorders brought by abuse, neglect physiological trauma or mental illness. The children that Allendale works with are in sincere need of help. Allendale gives hope by providing safety, comfort, education, and therapy. You can instill hope by providing guidance and love.

Child Welfare Association of Illinois

Our mission is to be the premier Illinois association that shapes practices and policies for the benefit of children, adolescents, and the families and the organizations that serve them.

Child Welfare League of America, Inc.

CWLA is a powerful coalition of hundreds of private and public agencies serving vulnerable children and families since 1920. Our expertise, leadership and innovation on policies, programs, and practices help improve the lives of millions of children in all 50 states. Our impact is felt worldwide.

Department of Children & Family Services

On this web site you will find timely information about Child Protection, Foster Care, Adoption, Day Care licensing and other services provided by the Illinois Department of Children & Family Services (DCFS).

National Runaway Switchboard

The mission of the National Runaway Switchboard (NRS) is to help keep America’s runaway, homeless and at-risk youth safe and off the streets. The National Runaway Switchboard provides education and solution-focused interventions, offers non-sectarian, non-judgmental support, respects confidentiality, collaborates with volunteers, and responds to at-risk youth and their families 24 hours a day.

Reclaiming Youth at Risk

Reclaiming Youth International (RYI) is dedicated to helping adults better serve children and youth who are in emotional pain from conflict in the family, school, community, or with self. The Circle of Courage® provides the philosophical foundation for the work of RYI. It suggests that children and youth do well when their needs of belonging, mastery, independence, and generosity are met.

Science & Arts Academy

Science & Arts Academy is an independent, co-educational day school serving gifted learners in Jr. Kindergarten through 8th grade.  Science & Arts Academy educates gifted children in an academically differentiated and enriched environment while recognizing the unique development of each child. Our supportive community encourages students to embrace their potential and cultivates their academic abilities, creative talents, and emotional growth.

United Way of Lake County

United Way of Lake County is preparing our children to succeed in a changing world by focusing on education and building safe and stable families.

Depression and Suicide

All About Depression

For more than 10 years providing accurate, current, and relevant information about clinical depression to the public click the link above.

Depression and Bipolar Support Alliance

The Depression and Bipolar Support Alliance (DBSA) is the leading patient-directed national organization focusing on depression and bipolar disorder. The organization fosters an environment about the impact and management of these life-threatening illnesses by providing up-to-date, scientifically-based tools and information.

National Suicide Bereavement Support Network

Since the setting up of this network in 1998 there has been an increase in the number of Support Groups around the country North and South. This is a very positive development and it shows to some degree that the awful stigma that has heretofore surrounded suicide is beginning to lift. This can be seen in the number of people who now feel that they can come forward and say they have been bereaved by suicide and not feel that they are in some way “strange” and get the support they need.

Suicidal.com

A place of hope and compassion for the severely depressed and suicidal.

Diseases and Conditions

Alzheimer’s Association

The Alzheimer’s Association is the leading, global voluntary health organization in Alzheimer’s care and support, and the largest private, nonprofit funder of Alzheimer’s research.

The National Association of the Deaf

The National Association of the Deaf (NAD) is the nation’s premier civil rights organization of, by and for deaf and hard of hearing individuals in the United States of America. Established in 1880, the NAD was shaped by deaf leaders who believed in the right of the American deaf community to use sign language, to congregate on issues important to them, and to have its interests represented at the national level. These beliefs remain true to this day, with American Sign Language as a core value.

National Down Syndrome Society

The mission of the National Down Syndrome Society is to be the national advocate for the value, acceptance and inclusion of people with Down syndrome. The National Down Syndrome Society envisions a world in which all people with Down syndrome have the opportunity to enhance their quality of life, realize their life aspirations, and become valued members of welcoming communities.

National Multiple Sclerosis Society

The National MS Society is a collective of passionate individuals who want to do something about MS now—to move together toward a world free of multiple sclerosis. MS stops people from moving. We exist to make sure it doesn’t. We help each person address the challenges of living with MS through our 50-state network of chapters. The Society helps people affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, and providing programs and services that help people with MS and their families move their lives forward.

Eating Disorders and Obesity

National Assoc. of Anorexia Nervosa and Associated Disorders

A non-profit dedicated to the prevention and alleviation of eating disorders since 1976.

Eating Kids

A collaborative community of parents, doctors and educators who fuel each other’s passion to eliminate these diseases through medical information posts, question-and-answer with community members and the relentless pursuit of new community members.

National Eating Disorders

The National Eating Disorders Association (NEDA) is a non-profit organization dedicated to supporting individuals and families affected by eating disorders. We campaign for prevention, improved access to quality treatment, and increased research funding to better understand and treat eating disorders. We work with partners and volunteers to develop programs and tools to help everyone who seeks assistance.

Health

The Cancer Wellness Center (Chicagoland)

Cancer Wellness Center was founded in 1989 to help people live better while living with cancer™ in Northbrook, Grayslake and Waukegan.

Drugwatch.com

Drugwatch.com reports on the latest information regarding dangerous drugs and defective medical devices. They provide the information you need, when you need it. Their Patient Advocates can answer your medical questions and point you to a specialist. They can also assess your situation and help you find an attorney to pursue a legal claim you might have.

Illinois Department of Human Services

To assist Illinois residents to achieve self-sufficiency, independence and health to the maximum extent possible by providing integrated family-oriented services, promoting prevention and establishing measurable outcomes in partnership with communities.

Mayo Clinic

Provides patient care, health, education and research information.

Points of Wellness – Acupuncture 

Anh Tran’s mission is to provide guidance for people to obtain maximum health through self-knowledge and a focused pathway, using the principles of Traditional Chinese Medicine.

Scott Chiropractic Associates

On-site chiropractic care by Dr. Scott, partnered with Points of Wellness.

Web MD: Better Information. Better Health™

WebMD is a provider of health information services to consumers, physicians and other healthcare professionals, employers and health plans through its public and private online portals, mobile platforms and health-focused publications.

Yoga Today™ Practice for Life

Discover a new way to do yoga. Search, stream, and download from our library of over 200 one-hour video classes – in settings that harmonize with the postures.

Marriage and Divorce

Divorce Care

DivorceCare is a friendly, caring group of people who will walk alongside you through one of life’s most difficult experiences. Don’t go through separation or divorce alone. DivorceCare seminars and support groups are led by people who understand what you are going through and want to help. You’ll gain access to valuable DivorceCare resources to help you deal with the pain of the past and look forward to rebuilding your life. There are thousands of DivorceCare divorce recovery support groups meeting throughout the US, Canada and in other countries around the world. There’s one meeting near you!

Mental Health

The Eye Movement Desensitization Reprocessing Institute

Eye Movement Desensitization Reprocessing (EMDR) is a comprehensive, integrative psychotherapy approach. EMDR was recognized by the American Psychiatric Association in 2004 and was determined to be an effective treatment for trauma

HealthyPlace America’s Mental Health Channel

HealthyPlace.com is the largest consumer mental health site, providing comprehensive, trusted information on psychological disorders and psychiatric medications from both a consumer and expert point of view.

National Alliance on Mental Illness

At the heart of NAMI’s mission is our grassroots and the sharing of information with people with mental illness, their families, friends, mental health professionals, and the general public. NAMI strives to offer hope, reform and health to our American community through support, education and advocacy efforts. Research is constantly providing us with new information about the brain and the nature of mental illnesses and, consequently, more effective treatments.

National Association of Therapeutic Schools and Programs

The National Association of Therapeutic Schools and Programs serves as an advocate and resource for innovative organizations which devote themselves to society’s need for the effective care and education of struggling young people and their families.

National Federation of Families for Children’s Mental Health

The National Federation of Families for Children’s Mental Health is a family-run organization that arose 20 years ago from a grassroots movement. Our membership includes more than 120 chapters and state organizations representing the families of children and youth with mental health needs. We believe that families should have a primary decision-making role in the care of their own children as well as in the development of policies and procedures governing care for all children in their community, state, tribe, territory, and nation.

National Institute of Mental Health

NIMH envisions a world in which mental illnesses are prevented and cured. The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. For the Institute to continue fulfilling this vital public health mission, it must foster innovative thinking and ensure that a full array of novel scientific perspectives are used to further discovery in the evolving science of brain, behavior, and experience. In this way, breakthroughs in science can become breakthroughs for all people with mental illnesses.

Obsessive-Compulsive Foundation

Founded by a group of people with OCD in 1986, the International OCD Foundation (IOCDF) is an international not-for-profit organization made up of people with Obsessive Compulsive Disorder (OCD) and related disorders, as well as their families, friends, professionals and others. The mission and goals of the IOCDF are to educate the public and professionals about OCD in order to raise awareness and improve the quality of treatment provided; Support research into the cause of, and effective treatments for, OCD and related disorders; Improve access to resources for those with OCD and their families; Advocate and lobby for the OCD community.

Hopeline

Hopeline connects survivors of domestic violence to vital resources, funds organizations nationwide and protects the environment.

Parenting

Mothers and More

Mothers & More is a non-profit organization dedicated to improving the lives of mothers through support, education and advocacy. We address mothers’ needs as individuals and members of society, and promote the value of all the work mothers do.

The National Infertility Association

RESOLVE: The National Infertility Association, established in 1974, is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.

Get In Touch

We offer daytime, afternoon, and evening hours.

Now accepting Blue Cross Blue Shield PPO, Medicare, and Medicare supplemental insurance.

Our office will assist with checking benefits and billing out of network providers.

Call

(847)-821-1450

Address

4180 Route 83 Suite 10 and 11, Long Grove, IL 60047

Hours

Mon – Sat: 9am – 9pm
Sunday: closed