Thank you for selecting Comprehensive Therapy Children’s Center for your child’s therapy needs. In order to expedite your first visit, we have provided the checklist below. Please print this page and attach it to the top of all completed forms.

___ Prescription from your child’s Pediatrician or PCP including diagnosis and therapy required
___ A copy of your child’s most recent Evaluation (if applicable, not more than 12 months old)
___ Current Insurance Card(s)

Download the following forms for completion & signature
Note: You may fill out the form fields in Acrobat Reader, print then sign and bring with you to your first visit. You may also print and fill out by hand if desired.
___ Evaluation Questionnaire

___ Patient Information

___ Patient Agreement

___ Patient Record of Disclosures
___ HIPAA

___ Receipt of Privacy Policy

___ Financial Policy


Please write any additional notes you may have here and bring with you to your first visit.