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Dawn M. Roy, LCSW

Counseling for Adults and Couples

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Forms

Click on any of the appropriate patient forms that you may need:

CT Teletherapy Agreement

Intake Form

Client Contact Info

Agreement To Pay

Cancellation Policy 

Office Policies

HIPPA Form

Release of Information

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Online Payments

Click on the logo to pay for your session or make a Co-pay

Contact Info

540 Tunxis Hill Road
Fairfield, CT 06825

Phone: 203.331.7458
Email: dawnmroylcsw@gmail.com

Fairfield Countys Finest
Featured in the Fairfield County Advocate.
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