Forensic Counseling and Evaluations, PLLC
8350 E Raintree Drive, Suite 120
Scottsdale, Arizona 85260
Voice: 480 840-0400
Fax: 480 840-0499
www.fceinfo.com
dr.d@forensicpsychinfo.com


Co-Parenting with Boundaries
Counseling Services Agreement

Sections completed:
 
 
 
 
 
 


Thank you for your interest in the Co-Parenting with Boundaries course. In an effort to limit the spread of COVID-19, the course has been moved to a HIPPA complaint, telehealth platform. Group members will be able to access the group using a computer or cell phone. Please see below for information about the upcoming groups. In order to confirm your seat in the course, you will need to complete all sections of this form and pay online. Please note that seats in each group are limited and group members are enrolled on a first come first served basis. Co-parents are not enrolled in the same group. Once registered, participants will receive further instructions for logging into the group. Please contact me if you have any questions.

Basics of the Group

 The group will include 4 weekly sessions, each lasting 2 hours (8 total hours of group counseling).
 The cost of the group is $375 per person, due as soon as possible (see below).
 Couples may NOT attend group together, but can attend separate groups.
 Group is first come first serve with registration.
 Clients can enroll in the group with or without a court-order.
 Initial documents must be completely filled out

Benefits of Participation

Each parent will:

 Become aware of his or her own inappropriate co-parenting behavior and take responsibility for changing that behavior.
 Learn tools for healthy co-parenting behavior.
 Learn tools to better communicate with his or her co-parent and children.
 Understand the consequences of his or her co-parenting behavior.


CREDENTIALS:

Dana Dalgleish, Ph.D.
Clinical Forensic Psychologist
PSY-005258

The cost of Co-Parenting with Boundaries is $375.00 and payment will be required prior to completing this registration.

If you have questions, or run into any issues in completing your registration, please contact Dr. Dalgleish at the email address at the top of each page.

Please begin by providing your name and Case #: