Thank you for choosing Just Right Challenge Therapy Gym for your child’s treatment needs. In this section, you’ll find a confidential developmental history form and our privacy policy. Prior to our initial visit with your family we need some additional information from you. Listed below is a checklist of the things we need which can be sent to us by mail or dropped off at our office. Your child’s file must be complete with all items prior to starting therapy.
Getting Started Check List:
Prescription from your child’s primary care physician with ICD code and frequency of visits.
Any current therapy evaluations completed in previous year.
Insurance information. Please copy the front and back of your primary and any secondary insurance.
Healthy Kids/Medicaid information. Please copy the front and back of your card.
Preauthorization. Please check with your insurance company to see if they require preauthorization for the services you are requesting.
We make every effort to work with families who may need financial assistance. If you have questions about accepted insurances, please contact our billing specialist, Cathy Sanderson Weeks at (603) 483-5127.
Thank you for choosing Just Right Challenge Therapy Gym for your child’s treatment needs. In this section, you’ll find a confidential developmental history form and our privacy policy. Prior to our initial visit with your family we need some additional information from you. Listed below is a checklist of the things we need which can be sent to us by mail or dropped off at our office. Your child’s file must be complete with all items prior to starting therapy.