Welcome to Pediatric Potentials!
We look forward to meeting you and your child. If possible, please complete the following before your first visit:
- Obtain a doctor’s prescription stating ‘OT evaluation and possible treatment.’ This can be faxed to 582-4148 or bring it with you to your child’s first appointment.
- Please collect any relevant medical, school, or therapy reports, copy and bring with you to your child’s first appointment.
- Please complete and submit online the following forms prior to your first appointment:
If you prefer to print and bring the forms with you please use these links for our forms.:
New Patient Information Sheet to Print
and, if appropriate:
- New Patient Information Form Newborn Infant
- Sensory Processing Disorder Checklist
- Consent to Telemedicine Form
- Photography consent/release form
For your appointments please make sure your child is comfortably dressed and is wearing sneakers.
Appointment Details:
- Each therapy session is 45 minutes or 1 hour
- Therapy sessions are catered to the client’s goals.
- Each treatment is creative and fun and changes depending on the needs of the client.
Insurance, Billing and Reimbursement
Pediatric Potentials is a preferred provider with all major insurances. We also bill Medicaid and CHIP. We accept all credit cards for any private payment or co-pay.