William G. Austin, Ph.D.
Licensed Psychologist
(303) 670-6767 voice
(303) 217-8990 fax
Lakewood, Colorado
Raleigh, North Carolina
Wilmington, North Carolina
Email: wgaustinphd2@yahoo.com
   

William G. Austin, Ph.D.
Licensed Psychologist
(303) 670-6767
voice
(970) 846-1157 cell
(303) 217-8990
fax

wgaustinphd2@yahoo.com
www.parentalgatekeeping.com

Mail: P.O. Box 3939
Evergreen, CO 80437

 

Northwest Colorado Psychological Services                         710 Kipling St.

737 Lincoln Ave., 2nd Floor                                                  Ste. 306

Steamboat Springs, CO 80487                                             Lakewood, CO 80215

 

Privacy policy:

Information is absolutely confidential and in accordance with Colorado Revised Statutes, mental health licensing act. (C.R.S. § 12-43-218).

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, or protect ours or others rights, property or safety.

Refund/Return policy:
Your credit card will be charged when you make your pre-payment. Cancellation of appointments must be made 48 hours in advance. If that occurs your credit card will be refunded.

Accepted Payment Methods: Visa, Master Card, American Express, Check/Money Order 

 CREDIT CARD BILLING FORM

[Fax or e-mail to Dr. Austin]

Down load Credit Card Form for Colorado

Name on Card: _________________________________________

Type of Card

                      Visa

                      Master Card

                      American Express

 
Card Number: ____________________________________


SVG Code (back of card): 
____________


Phone Number associated with card: _________________________________

I authorize Dr. William G. Austin to charge my credit card for psychological services rendered                                 [type initials]

 

Signature (if faxing):                                                                                    


Date:                                                                                                  

  Services Available in Colorado and North Carolina Locations
Lakewood, Colorado
Cary and Wilmington, North Carolina