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Intake Form

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Step 1

Contact us by submitting the form below to inquire about services.

Step 2

An agency representative will contact you to answer any questions you may have and to have you complete an intake questionnaire. The intake questionnaire consists of basic information about your child and needs, as well as your insurance information and diagnostic report.

Step 3

You'll be placed on our waitlist and availability to enroll is assessed based on many factors, such as location, team availability, family needs, etc. Once a team is available to begin services, the enrollment process will begin.