Please print and complete. Completed form may be faxed to 214-750-1971 or brought with you to the first appointment. Copies of the form are also available at Dr. LaValle's office.
Note: You will need Adobe(r) Reader(r) to view PDF files. If you do not have it, you can download it for free.
Michael LaValle, Ph.D.
8330 Meadow Rd
Dallas, TX 75231
Communal meditation - Monday 11/22 - 6:00-7:00