Contact UsPlease complete the following items to request an appointment with our office. We will do our best to respond within 48 hours. Your Name * First Name Last Name Your Child's Name First Name Last Name Your Child's Age Phone (###) ### #### Email * Preferred Therapist No preference/First available Erin Adamitis, PsyD Lauren Cunkleman, MA, BC-DMT, LPC, NCC Elizabeth Scheirer, MA, LMFT Kaitlyn Clark, MA, BC-DMT, LPC Ashley Marcy, M. Ed. Matt Ercolani, MS, LPC, NCC Ian Vereen, MA, MT-BC, NMT Dana Greenlaw, MS Jessica Hegarty, MA, LBS Dr. Shehara Yoosuf, PsyD. Dr. Alana Summers-Plotno, PsyD Service Requested Other/Unsure Individual Therapy Assessment Group Therapy Parent Training Presenting Issue * Please briefly describe why you are seeking services for you or your child Therapy Expectations * Please briefly describe the personality/approach of your ideal therapist for you/your child Scheduling * Please note that requiring an evening session may lead to a wait on scheduling as these times are consistently booked. If you have any flexibility to start off in a morning/afternoon slot, you would then get first preference on an evening slot as soon as one does open with your therapist. I am/My child is able to attend a session earlier in the day (9am - 3pm) I need/My child needs an evening session (4pm or later) No preference/first available appointment Virtual In-person only Exton office only Downingtown office only Private Pay Acknowledgment * I acknowledge that Pediatric Psychology Center of Chester County is a private practice and does not accept insurance Would you be willing to work with an intern at a reduced rate? * Yes No Thank you for reaching out to us. We will do our best to respond to your request via text or email within 48 hours. General Contact Infoinfo@chesterpsychology.comP: 610.723.8176 (call or text)F: 610.273.5598 Locations 110 Hopewell Rd. Suite 220Downintown, PA 19335 356 N. Pottstown Pike 3rd Fl.Exton, PA 19341
