HomeMy WebLinkAbout11-30-05
APPLICATION OF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION .....,
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INRE:
RIEGLER SHIENVOLD AND
ASSOCIATES and DY ANNE SAGE,
QCSW, LCSW
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PETITION FOR DESIGNATION
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AND NOW COMES Smige~ Anderson & Sacks, LLP, attorneys for Riegler Shienvold and
Associates and Dyanne Sage, QCSW, LCSW, and represent as follows:
I. Riegler Shienvold and Associates is a professional group practice offering services for
psychological counseling, medical services and social work services, with its principal office located at
2151 Linglestown Road, Suite 200, Harrisburg, Dauphin County, Pennsylvania 17110.
2. Dyanne Sage, QCSW, LCSW, is a licensed social worker employed by Riegler Shienvold
and Associates and has substantial experience preparing home studies and pre-placement reports for
adoptive placements that have been accepted in Pennsylvania as well as in a multi-state placement
involving the Interstate Compact for the Placement of Children.
3. Dyanne Sage, QCSW, LCSW, now desires to be designated by the Cumberland County
Court, pursuant to the Adoption Act of Pennsylvania, 23 Pa.C.S.A. 2101, et. seq., as approved to do
such home studies and any post placement supervision for adoption placements involving Cumberland
County.
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4. A general description of the services of Riegler Shienvold and Associates is attached
hereto as Exhibit "1" and the curriculum vitae ofDyanne Sage, QCSW, LCSW, is attached hereto as
Exhibit "2".
WHEREFORE, Petitioners respectfully request this Honorable Court to designate Riegler
Shienvold and Associates and Dyanne Sage, QCSW, LCSW, as approved to prepare pre-placement and
post placement supervisory reports as required by the Adoption Act in Cumberland County.
Dated:~ /.ff
,2005
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Stuart S. Sacks, Esquire
J.D. No. 18059
SMIGEL, ANDERSON & SACKS, LLP
River Chase Office Center, 3rd Floor
4431 North Front Street
Harrisburg, P A 1711 0
(717) 234-240 I
Attorneys for Petitioners
VERIFICA nON
I, Arnold T. Shienvold, verify that the statements contained in the foregoing Petition for
Designation are true and correct to the best of my knowledge, information and belief. I understand that
false statements therein are made subject to the penalties of 18 Pa.C.S.A. ~ 4904, relating to unsworn
falsification to authorities.
Date: ////7-of
RIEGLER SHlENVOLD AND ASSOCIATES
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By: ,,/ <<'7, 4
'Old . Shienvold -
VERIFICATION
I, DY ANNE SAGE, QCSW, LCSW, verify that the statements contained in the foregoing
Petition for Designation are true and correct to the best of my knowledge, information and belief. I
understand that false statements therein are made subject to the penalties of 18 Pa.C.S.A. ~ 4904,
relating to unsworn falsification to authorities.
Date: //- /7- C:>.J
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Dya e Sage, QCS ,Lcfiw
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Mental health rofessiona\s
providing the highest 9ualit~ of
care to individuals, families, and
organizations.
Riegler, Shienvold &-
Associates
T d, 717-5+0-1) 1;
RESUME
Dyanne [Seymore] Sage
714 Kent Drive
Mechanicsburg, PA 17050
717-732-3033
Dyannes@att.net
EDUCATION
The Pennsylvania State University
State College, PA
Bachelor of Science
May 1980
Temple University
Philadelphia, PA
Master of Social Work
May 1997
PROFESSIONAL
Licensed Social Worker, State of Penna., 1997
Qualified Clinical Social Worker, State of Penna., 2001
Licensed Clinical Social Worker, State of Penna., 2002
Member of National Association of Social Workers, 1983
EMPLOYMENT
Psychotherapist
Riegler, Shienvold and Associates
Harrisburg, PA
January 1998 to present
Psychotherapist using individual and group therapy. Conduct at home visit
evaluations for custody evaluations, administration of certain psychological
evaluations.
Participated in research and implemellt~tion of recent HIPAA legislation.
Medical Social Worker
Hospice Preferred Choice
Harrisburg, PA
March 1998 to January1999
Individual and family assessments. Conducted bereavement counseling for the
terminally ill and their families.
Psychotherapist
Holy Spirit Hospital April 1986 to March 1998
Community Mental Health Center - Outpatient
Provide individual and group psychotherapy. Areas of interest: women's issues,
developmental lifetime changes, treatment of pain, infertility and parenting
issues.
1!:m2 to 1994 Member of Continuous Quality rmprov~ment and Peer Review
Team.
1995 to 1996 Conch Idp.rl special research project to facilitate the revision of the
format for treatment plans to be in compliance with all regulatory agencies and
third party reimbursers.
Case Manager
Center for Industrial Training
July 1985 to January 1986
Managed case load of individuals with developmental handicaps to ensure work
preparedness.
Social Worker
The Methodist Children's Home
Waco, TX
May 1983 to AUQ!Jst 1984
Intake evaluations. Managed an entire caseload of children in foster care.
Conducted adoptions, adoption home studies, and court presentations.
Substance Abuse Counselor
UA Army Drug and Alcohol Prevention and Control Program
Fort Hood, TX January 1980 to May 1983
January 1980 to January 1982: worked in. in-patient residential treatment
facility, providinQ.indivfdual, group and psycho-educational courses to the
polysubstance abuser.
January 19982 to May 1983: Worked in outpatient department providing
individual and group psychotRefapy to polysubstanee abusers. '