top of page

Request for Evaluation Services:

*Please note that Dr. Sam Gray will be out of the office from Monday, 5/20/24, through Monday, 5/27/24, and will begin responding to requests upon his return 5/28/24. We apologize for any inconvenience and look forward to following up as quickly as possible. 

Please fill out the form below in order to initiate services for psychological and forensic evaluations. You will receive a call from one of our doctors or clinicians within 2-3 business days. If requesting services for a minor, please use their name and birth date and note in the additional comments section the contact (parent/guardian) name. We are currently scheduling approximately 10 weeks out. 

Address

100 S. Marshall St., Ste 1

Winston-Salem, NC 27101

Phone

336-276-1278

Email

Gender
Type of Assessment Requested
Thanks for submitting!
BW 30.JPG
bottom of page