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310.365.0500
  • About Us
    • Our Team
    • Blog
  • Our Services
    • Occupational Therapy
    • Speech-Language Therapy
    • Physical Therapy
    • Orofacial Myofunctional Therapy
  • PACE
    • PACE testimonial
  • What to Expect
    • Payment Options
    • Intake Forms
  • Does My Child Need Help?
  • Contact Us

Intake Forms

Everyone Must Complete:

  • Acknowledgement of Receipt of Privacy Practices & Authorization and Release Form
  • Notice of Privacy Practices
  • Authorization for Photography and Recording

If Private Pay or Insurance Must Complete:

  • Credit Card Authorization Form
  • Financial and Office Policies

If Insurance Must Complete

  • Insurance Intake Form

If Regional Center Must Complete:

  • Regional Center Credit Card Authorization Form
  • Regional Center Financial and Office Policies

Intakes by Discipline:

  • Occupational Therapy Intake (OT Intake)
  • Physical Therapy Intake
  • Speech Therapy Intake for children OVER age 1
  • Speech Therapy Intake for children UNDER 1

Kids Therapy Made Simple

Kids Therapy Made Simple offers a variety of pediatric therapeutic services including individual occupational therapy, physical therapy, speech-language therapy and orofacial myofunctional therapy to facilitate successful social, emotional, physical, behavioral and cognitive development of young children and their families.

Contact

info@kidstms.com
310.365.0500
822 S. Robertson Blvd, Suite 202
Los Angeles, CA 90035
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Open Hours

Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM

© 2019 Kids Therapy Made Simple | Site by Glantz