Ketty Patiño Gonzalez
5915 Ponce de Leon Blvd, Suite 49
Coral Gables, FL 33146
Phone: 305-668-0355
FAX: 305-668-5311

Forms

Language Selector: French

Spanish

English

For your convenience, we have made most of our forms accessible online.

Child Intake Form

Adult Intake Form

Notice of Privacy Practices

Information Release Form

Informed Consent Form

Document for remote-access credit card payment