Contact — Dr. Sophia Sandhu, R.Psych.

Please complete the following intake form in order to determine whether Dr. Sandhu is the right fit for your needs. Someone will reach out to you within 5 - 10 business days to request further information or discuss next steps. Please send a follow up email if you do not hear from us within 10 business days.

info@drsophiasandhu.com
(236) 999-3663

Surrey, BC

Client Name

First Name

Last Name

Client Date of Birth

YYYY

Client Pronouns

Name(s) of Legal Guardians

First Name

Last Name

First Name

Last Name

Phone number

(###)

###

####

Marital Status of Legal Guardians

If Other, please explain:

Are all legal guardians consenting to and/or participating in this assessment?

Please note that consent from all legal guardians is required in order to provide psychological services, including assessments to children under the age of 18 in British Columbia. We cannot provide services if guardianship is in active dispute.

If no, please explain:

Other legal guardian's email address

An email address for both parents is required to send consent forms Indicate n/a if not applicable (i.e., only one parent or guardian)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What are your concerns and what questions are you hoping to have answered by this assessment?

What type of assessment are you interested in for your child?

Autism Spectrum Disorder Assessment

Psychoeducational Assessment

ADHD Assessment

For Autism Spectrum Disorder assessments, it is required that children under the age of 6 are also seen and assessed by a paediatrician and a speech-language pathologist. Please identify which providers have already been seen.

Dr. Sandhu cannot formalize an autism diagnosis without written reports from both of these providers.

Paediatrician

Speech-Language Pathologist