Psychological Testing Consent Form
Dr. Alexandra Pillat, from One Life Child Development Center, is working as an Educational Consultant for Mill Springs Academy. Dr. Pillat will be conducting abbreviated psychological evaluations that will specifically look at students’ cognitive, academic, and social/ emotional/ behavioral functioning. These measures will be completed at Mill Spring Academy and remotely via online parent questionnaires. This evaluation does not replace a full, comprehensive psychological evaluation. Therefore, this abbreviated testing will not provide a specific DSM-5 clinical diagnosis. The information from these measures is meant to inform students’ academic plans at Mill Springs. Dr. Pillat will conduct a short, virtual feedback session with parents to discuss the testing results. A written summary of scores and recommended accommodations will be provided to Mill Springs Academy and to parents.
The cost for the abbreviated psychological evaluation is $1,000. Payment for testing will be made directly from Mill Springs Academy with Mill Springs Academy covering $500 of the testing and parents/guardians covering the remaining $500. Mill Springs Academy will invoice parents/guardians for the $500 through FACTS.