Psychological Assessment Forms

Please download, complete and mail the forms below:

Psychological Assessment Brochure (PDF 112K)

FAQ Sheet (PDF 60K)

Testing Referral Form (PDF 46K)
(to be completed by the student)

Testing Consent Form (PDF 70K)
(to be signed by parent/guardian unless student is over 18 years of age)

Release and Request of Information Form (PDF 96K)
(to be signed by parent/guardian unless student is over 18 years of age)

Please return the forms to Antioch with a $50 check or you can pay the $50 by Visa Mastercard. This will assure you will be considered next for an appointment. We will hold the check/credit card until you come in for testing. Please do not hesitate to call 603-352-1024 should you or your family have additional questions.