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    6201 West Main Street Suite 130 | Maryville, Illinois 62062
    Robin.Myers@MidwesternPsychologicalConsultants.com
    Phone: 618-979-5087 | Fax: 618-551-2802

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    Client Forms

    If you are new to the working with me, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

    Client Intake Form

    Information Sheet

    Limits of Confidentiality

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

    Authorization for Release of Information


    6201 West Main Street Suite 130
    Maryville, Illinois 62062

    Phone: 618-979-5087
    Fax: 618-551-2802
    Robin.Myers@MidwesternPsychologicalConsultants.com

    Contact Me Today

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    Dr. Robin Myers, Psy.D., ABPP
    Robin.Myers@MidwesternPsychologicalConsultants.com | Phone: 618-979-5087 | Fax: 618-551-2802

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