Sign up on our Wait List for services. We will contact you a soon as we have availability. If we haven't contacted you in three months, please reach out to us again. We appreciate your understanding. Thank you.

Your child's DOB *

Parent's Name *

Phone *

Email Address *

Primary Health Insurance company *

Indicate if you are willing to do private pay

Therapy_Requested_(check_all_that_apply)* Therapy_Requested_(check_all_that_apply)* Speech-Language Therapy Occupational Therapy Feeding Therapy ABA Therapy (Not on waitlist. Services available) I don't know. Please, screen my child.

Is your child enrolled in Step Up?

Does your child attend school or daycare?

Describe your concerns *

Which kind of therapy is right for your child? * Which kind of therapy is right for your child? * Online (Teletherapy) In person (Face to Face) Both I don't know

Do you have a Dr. referral or prescription for therapy? * Do you have a Dr. referral or prescription for therapy? * Yes No

I've read the privacy policy I've read the privacy policy Accept