Forms

We are always happy to speak with interested families regarding services that are available at the clinic. You may contact us by filling out a request on the contact page. Please note it may take up to five business days to respond.

If you are interested in joining our ConnectEd family, please fill out and return the Enrollment and Acknowledgement forms to us using one of these methods:
By email: christine@connected.us.com
By US mail: 1361 S Winchester Blvd, San Jose CA 95128

Upon receipt, we will be in touch to discuss how ConnectEd can best support your family.