Contact

Use the form below to get started
and check availability for play therapy

Parent Information

Parent Name(Required)
This field is hidden when viewing the form
If the child’s caregivers are divorced then a copy of the complete divorce decree MUST be provided to Sheila Wessels Therapy before the family will receive services.

Consenting Caregiver

Please provide the name, phone number and email address of the other consenting caregiver. If you have sole custody, please type N/A.
Consenting Caregiver Name(Required)
This field is hidden when viewing the form

Other