Clarence M. Bergeron, Ph.D.
Licensed Psychologist
623 Belanger Street
Houma, LA 70360
(985) 851-6257
Fax (985) 851-6065
email cmbergeronphd@aol.com
Doxy.me address doxy.me/drcbergeron
(DO NOT USE EMAIL TO MAKE OR CANCEL APPOINTMENT - CALL)
One of these five forms should be downloaded, printed and filled out before your first appointment. This will save time when you arrive for your appointment. Please click on the appropriate link below to download the form. Fill out the form and mail or bring it to the office before your first appointment. You will need Adobe Acrobat Reader to print the forms. If you need this free program, please click here to download it.
I. Adult New Therapy Patient (18 years of age and older)
II. Adolescent New Therapy Patient (14 to 17 years of age)
III. Learning Disability or ADHD Evaluation (6 years and up)
IV. Evaluation Checklist Intellectual Disability