2022 Summer Therapy Program

Registration Request

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Thank you for your interest in our summer program.

As a potential new client there are a few steps to take to check your eligibility for the program:

  1. Please fill out the below form. You will receive a reply in 2 business days

  2. We will check your insurance benefits to see if they will pay for the program. If insurance does not cover you will be provided with a private pay option

  3. We will schedule an intake

  4. Once the intake is complete & eligibility for our program is confirmed a non-refundable registration fee of $250 will be due at that time

Program Registration Request for:

For quicker review please upload a picture of the front & back of your insurance card.-OPTIONAL

Upload File
Upload File
REQUESTED ATTENDANCE SCHEDULE: In order for us to adequately staff, we request that you select the schedule that you would like your child to maintain for the entire summer (i.e. Morning students will always be morning students/afternoon students will always be afternoon students/full day students will always be full day students). Choose only (1)
CT Weekly Schedule: Please check the weeks your child will be attending
SC Weekly Schedule: Please check the weeks your child will be attending

Thanks for submitting your registration request!

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