Contact Us

To learn more about our services or to schedule an appointment, please contact:
thereservoirgroup@labschool.org
(202) 349-8640

Student/Child Information

Name:

First Name

Last Name

Age:

Enter your child's age

DOB:

Grade Level:

Select your child's grade level

School:

Name of child's school

Caregiver Information

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reason for evaluation/therapy/consultation:

Which clinical service(s) are you interested in? (Check all that apply)

Occupational Therapy

Psychology & Wellness

Speech, Language & Literacy

I am interested in the following services (check all that apply):

Evaluation

Therapy

Consultation