Downloadable intake documents:

Face Sheet & Release Form

Payment Contract

Signature Page

Sensory Questionnaire
 

Consent Form

After you read carefully through our Clinic Introduction and Policies, please fill out the documents above and return them to our office. Make sure you complete the Payment Contract.

Once we receive all your required information, your child will be placed on the waiting list. We will schedule you for an initial evaluation as quickly as possible.

Do not forget to include:

1. Your child’s Referral

2. Copies of your insurance cards, front and back

3. All requested forms, completed and signed

4. Alternate phone numbers

5. Current evaluations or clinical documentation, if applicable

If you need help completing your child's registration, feel free to email Jenn. You can also call during office hours, Monday through Friday, 9am to 3pm.