Intake Form

 

Please download and complete the form below. Please bring this form with you the day of your childs evaluation.

 

 

 

 

 

PATIENT FINANCIAL RESPONSIBILITY POLICY

 

Thank you for choosing Right Starts Occupational Threapy as your therapy provider!!!  We are committed to building a positive relationship with you and your family!

 

We are currently accepting Blue Cross Blue Shield. We are out of network with all other insurance companies at this time.  However, at the end of each session we will provide you with a detailed billing summary that you can submit to your insurance company for reimbursment.  Please note that it is your responsibility to develop a relationship with your insurance company and become familiar with the coverage details of your specific plan. We will gladly provide any documentation required. Full reports are subject to an additional fee for write up time.