Please Complete the Entire Contact Information Form and Submit for a Chance to Win a Free Intensive Therapy Session
This form is to be used by parents/caregivers of children with disabilities to apply for a chance to Win a Specialized 3 week Intensive Therapy Session. The questions allow us to determine if your child would be a candidate for the intensive therapy; therefore, please be thorough with your answers.
If you are a business attempting to contact us, please use the email or phone number provided on our Contact Us page.