Submit a Referral

The Referral Process

1. Fill out the form below to begin the referral process.
2. Our office will send your form to your primary care physician.
3. Your primary care physician will make an order send the signed form to our office.
4. We wait to receive authorization from insurance company
5. Evaluation will be performed on your child
6. Wait for authorization to begin treatment
7. Begin therapy treatment on your child