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AccessOAP Intake
AccessOAP Intake
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2023-02-24T19:38:41+00:00
Parent's Name
*
First
Last
Child's Name
*
First
Last
Child's Date of Birth
*
Month
Day
Year
Best phone number to reach you at:
*
Email
*
Current school or daycare
*
Tell us a bit about your child
*
AccessOAP Funding
*
My child has received AccessOAP funding
My child is on the AccessOAP waitlist
Which programs are you interested in?
*
Physiotherapy (infant development, balance, coordination skills, strength)
Occupational Therapy (infant development, feeding, fine motor/handwriting, sensory processing, gross motor)
Hydrotherapy (Physiotherapy or Occupational Therapy in the pool)
Speech and Language Therapy (AAC, delayed speech, articulation, language skills)
Music Therapy
ABA - 1:1 Therapy
ABA - Social Skills Group
Social Work
How did you hear about us?
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