Contact Information

First Name

Last Name

Email Address

Phone

Number of children seeking therapy services

Child Information

How did you find us?

Why are you seeking services?

What is your standing appointment availability?

Please select multiple time slots for your standing appointment. When making your selection for a child please consider your fall schedule and sports as appointments will be recurring at the same time each week. Our staff will try to accommodate changes as best they can. Weekday appointments from 3:00 to 6:00 are in high demand, please consider dismissing your child from school early for an appointment, on request we can provide you with a medical note for the absence.