Dance Therapy
Dance Therapy
Greensboro Dance & Drama Therapy (336) 698-6723
Greensboro Dance & Drama      Therapy(336) 698-6723

Therapy Forms

Greensboro Dance & Drama Therapy

FORMS to complete prior to first session

Disclosure statement for clients
AWdisclosurestatement-consent to treat 4[...]
Adobe Acrobat document [14.0 KB]
Client Rights
Client rights-grievances-Exp of office 4[...]
Adobe Acrobat document [42.3 KB]
Court Policy
court policy 4-24-17.pdf
Adobe Acrobat document [12.2 KB]
Angela's Disclosure Statement for Clients (in Spanish)
AW Disclosure Statement _Spanish_.pdf
Adobe Acrobat document [27.9 KB]
Adult Intake Form
adult intake form.revised.doc
Microsoft Word document [55.5 KB]
Check List for Children Under 5 yrs. of Age
CHECKLIST FOR CHILDREN UNDER 5.doc
Microsoft Word document [33.5 KB]
Check List for Children Under 5yrs (Spanish)
ChecklistforChildrenunder528Spanish29-1.[...]
Microsoft Word document [23.1 KB]
Child/Teen Intake Form (to be completed by parent)
teen-child+intake+form+completed+by+pare[...]
Microsoft Word document [71.5 KB]
Child/Teen Intake Form (child/teen complete)
child-Teen INTAKE FORM to be completed b[...]
Microsoft Word document [35.0 KB]

Information Forms for Personal Use

Consent to release information form
Consent for Release of Confidential Info[...]
Adobe Acrobat document [78.7 KB]
Consent for Release of Information for DSS
Consent for Release of Confidential Info[...]
Adobe Acrobat document [80.2 KB]
Parents commonly asked questions
Parrents commonly asked questions.pdf
Adobe Acrobat document [6.9 KB]
How do I Prepare my child for therapy/ what is expected of me?
How should I prepaire my child therapy-w[...]
Adobe Acrobat document [17.1 KB]
How to talk to a child about a parent's addiction
What to Tell Children About a Parent eth[...]
Adobe Acrobat document [7.0 KB]
Why choose dance or drama therapy?
Why+should+I+choose+dance+or+drama+thera[...]
Adobe Acrobat document [6.3 KB]

Make a Credit Card Payment with PayPal

Sorry on line bill pay is not available on mobile devices at this time.

Please contact Angela directly or logon with a desktop to make a payment

Make a payment for therapy services

Therapy ServicesSliding Scale

Make a payment for supervision services

Payment of supervision services with a credit card have a surcharge added.

If you wish to avoid this surcharge send a check to:

5603 B West Friendly Ave #103

Greensboro, North Carolina 27410

Rates minus the surcharge are as follows:

Individual $100/hour, Tridatic $50/hour

Group (for 2 hours) split by three people $100, by four people $75, by five people $60

Sliding Scale

Learn how to communicate what is too deep, too fine for words.

Few things are more frustrating and disheartening than watching your child suffer through a mental health ailment or watching them try to overcome an addiction. Likewise undergoing these challenges yourself is also debilitating. When these unenviable circumstances occur, it’s important to get help.

Things can get better!

Call Angela.

 

Email:

Angela@dance-drama-therapy.com

Contact via email


Phone:   (336) 698-6723 

   
Mailing address:

5603 B West Friendly Ave Suite 103 Greensboro, NC 27410.

 

Office Hours:

By Appointment Only.

 

Delays and Closings follow the Guilford Co. School System.

2 hr delay = open at 10 AM.

 

Most urgent appointments can be accommodated within 48 hrs.

All emergencies call

911 or National Suicide Prevention Hotline at 800 273-8255.


Use our contact form to inquire about any questions, comments, or concerns or if you wish to be added to our mailing list.  We will respond to you as soon as we can!

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2012© Angela Wiley