Intake Materials

In preparation for a consult with Dr. Millette, begin to fill out the Assessment and Weekly Schedule to the best of your ability. Please review/return (signed) the Release of Liability. When the Assessment, Weekly Schedule, and Release of Liability have been completed, please e-mail to info@angeliquemillette.com the evening prior to your consult so  Dr. Millette may review before the scheduled appointment.

Assessment
Baby-Child (0-5 yr)

complete via Google form
download to computer

Assessment
Child (6-14 yr)

complete via google form
download to computer

Sleep/Feed Diary

Blank white paper, fountain pens, ink bottle, and eucalyptus branch on textured brown background.
download to computer

Release of Liability

Close-up of a person signing a document with a fountain pen.
download to computer

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