Caroline Paltin, Ph.D. Licensed Psychologist,#PSY14274
Contact Dr. Paltin
Dr. Paltin's Scholarly Presentations
Mindful Life Focus Community
Graduate Student's Corner
PSY 628 Group Psychotherapy
Student Scholarship Conference
Consultation Group Monthly info
Registration and Payment for Workshops and Groups
Participant Profile Form
Resources and Links
Participant Profile -
Please complete for both your child and any sibling. Separate forms for each.
Indicates required field
Name(s) of Parents
Who should we contact in case of emergency (supply name and cell phone number)
Special Needs (Specific Conditions and Challenges
Does your child know his/her diagnosis?
What do you hope to gain from your child's experience with Spectrum Therapeutic Theatre?
Top Three SOcial Issues for your Child?
Please describe any issues you feel would be helpful for staff to know regarding your child's conditions
What are your child's interests and strengths?
I give permission to take video/photos of my child during class which may appear on website (pictures will be made available to families at no charge)
You can pay for Consultation Groups and Life Focus Meetings via PAYPAL, by or by calling (657-333-0824) and we will accept MasterCard and Visa over the phone. There is a $2.00 service fee.