Contact Us

10632 Little Patuxent Parkway
Suite 327
Columbia, MD 21044

443-864-5647 – office
443-276-0905 – fax

Client Information

I hereby voluntarily consent for the above named client to receive the following services from LIGHTHOUSE CENTER FOR THERAPY & PLAY, LLC


Lighthouse Center for Therapy & Play is dedicated to maintaining the privacy of your personal health information. Any information included on this form will only be seen by professionals affiliated with our practice, and with the expressed purpose of coordinating support services for you and your family
Please download, print and complete these forms and bring them to your first session. If you are unable to do this, please plan to arrive at least 10-15 minutes prior to your scheduled appointment time, so that you are able to complete them prior to your first session. We look forward to seeing you soon!