Get Started With Us!

We are eager to learn about your child! Background information is imperative for us to know if your child is eligible for treatment and how we can best serve your family.

Please add anything else you feel is of importance in the Additional Information text box.

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Child's Information

Child's Name *

First

Last

Child's Date of Birth *

Child's Gender *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Diagnosis *

Additional information you'd like to include

Where are you seeking therapy services? *

In-Clinic (Barrington, NH)
In-Home

Parent/Guardian Information

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Confirm Email

Parent/Guardian Phone *

Phone

Get Started With Us!

How did you hear about us?

Child's Information

Parent/Guardian Information

— email us —

info@seacoastaba.com

— Location —

1037 Calef HWY
Barrington, NH 03825.

— call us —

(603) 359-0549

— Facebook —

Follow Us

— Insta —

Stay Connected

Get Started With Us!

How did you hear about us?

Child's Information

Parent/Guardian Information

— email us —

info@seacoastaba.com

— Location —

1037 Calef HWY Barrington, NH 03825.

— call us —

(603) 359-0549

— Facebook —

Follow Us

— Insta —

Stay Connected

1037 Calef HWY
Barrington, NH 03825.