Let's get started

Tell us about your child. We'll email you today with what happens next.

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Step 1 of 3

Website

About you and your child

Takes about a minute. No account needed.

Parent / guardian full name*

Please enter your full name.

Phone*

Please enter a 10-digit phone number.

Email*

Please enter a valid email address.

Child's full name*

Please enter your child's full name.

Child's date of birth*

Please enter a date like 04/15/2022.

What brings you in

This helps us match you with the right therapist.

What are you hoping to work on?* Check all that apply.

Speech/communication Motor skills/coordination Sensory processing Feeding/eating Social skills Behavior Not sure, I'd like an evaluation Other

Please choose at least one.

Has your child had an OT or Speech evaluation at another facility in the past year?*

Yes No

Please choose yes or no.

Diagnosis (if any)

Insurance and scheduling

Last step. We check benefits before your first visit.

What is your child's primary insurance?*

Please choose your child's insurance.

Does your child have a second insurance plan or waiver?*

Yes No

Please choose yes or no.

What is your child's secondary insurance?*

Medicaid or PeachCare Katie Beckett Deeming Waiver Another private plan I'm not sure

Please choose one.

Which location works best for you?*

North Decatur Conyers Either works

Please choose a location.

How did you hear about us? (optional)

Pediatrician name (optional)

Comments or questions (optional)

Last step

The Progress Village

Inquiry received

Weekly availability

Share the days and times your child can attend so we can look for suitable openings.

Your inquiry is saved.

Your information is kept private.