Pediatric Behavioral Health Resources, LLC 103 Hwy 13 South Waverly, TN 37185   We have years of experience helping families deal with problems related to a variety of problems, including Autism, ADHD, divorce, death, anxiety, attachment disorders and more!   Order Form Consulting Services   Please print this order form, fill out information and send to the address above.   Please check which service you are interested in purchasing: EMAIL OR REGULAR MAIL CONSULTING RESPONSE COST     Short 1-page response to your question or problem. $  10.00    Detailed 2-3 response to your question or problem and suggestions for how to correct it. $  30.00                Sub-total:                 Total Amount Due

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Send your question or problem to the address at the top of this form along with your check, money order, cash, or credit card information. If you would like to speed things up, fax your request to the following number: 865-995-1296. If you have problems or questions, please call 865-995-1296.