Forms to Get Started
Please download, print, and complete the following documents prior to your first appointment.
Provides important background information about your child, including complete medical history and developmental history.
Discusses important Therapy Connections policies and provides authorization for our team to evaluate and/or treat your child.
Important information about our policy for missed, late, and cancelled appointments due to various circumstances.
Agreement for how any disputes or controversies will be handled between Therapy Connections, LLC and patient and/or patients' parents or legal guardians.
Authorization to release medical records, testing, and other information necessary to provide treatment to your child.
Provides us with a complete list of your applicable insurance so that we may appropriately handle any billing.
For orthopedic therapy cases, provides complete medical history pertinent to therapy services.
Other Specialty Forms - Only if your therapist asks you to complete:
Provides feedback on how your child responded to our Therapeutic Listening Program.