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Schedule an Appointment for a Child

Please fill out the following form.

Child's Date of Birth
Month
Day
Year
I am interested in scheduling the following appointment for my child:
Screening & Consultation (15 minutes)
In-Home Evaluation (60 minutes)
In-Home Treatment Session (30 or 60 minutes)
Telehealth Evaluation (60 minutes)
Telehealth Treatment Session (30 or 60 minutes)
All-Inclusive Aerial Arts Workshop (60 minutes)
Preferred Date and Time
Month
Day
Year
Time
HoursMinutes

Please note that completing this form does not confirm the date and time of the session. A confirmation will be sent to you via call, text, or email once your appointment is finalized.

Additionally, liability waivers, consent forms, and any necessary documents will be sent to you via email. These must be completed and submitted prior to the session.

Payment Information:

  • Payment is due at the time of service.

  • Accepted payment methods: Zelle, Venmo, or cash.

  • We do not accept insurance.

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