Forms

Below are the forms you will need to complete prior to beginning therapy. 

Below each item is a short explanation of the form and its purpose. Click on the picture to download the form (Link will open in a new window, you must have Adobe or other PDF reader to view files).

Developmental History / Intake Form 

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The purpose of this form is to gather pertinent information regarding your child's first years of life which may be impacting her current level of functioning. This form also provides us with the information needed for insurance purposes.

Health Insurance Information Form 

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Please fill out this form if you would like us to send a bill to your insurance. This is a courtesy service for our families, and in no way implies that we have a contract with your provider for payment. Many families are able to receive some reimbursement at "non-contracted provider" rates.