Age & Grade Level*
Emergency Contact Name & Phone Number (other than parent)*
Gender Identity (Optional)
School your child attends & method of dismissal (car rider, aftercare, walker)?
Is it OK to leave a detailed message on your voicemail?
You can pay using Venmo @Manda-Galin or Zelle using our email: email@example.com
Healthy Happy Minds founder, Manda Galin, L.C.S.W. is a licensed psychotherapist with over 30 years of counseling experience with children and teenagers.
We're not around right now. But you can send us an email and we'll get back to you, asap.