

Alicia Vidal-Zas, Psy.D. P.A
Psychological, Counseling and Behavioral Group
Contact Us: (305) 221-8200
Forms for ages 10 and under
Download and complete the following forms to be brought upon initial consultation:
Download form below, select footer and provide patient name and insurance member ID
*If manually entered, ensure information is provided on each page.
For children ages 6+, the parent(s)/guardian should complete the questionnaire below.