Patient Intake Form
Call our office at 405-513-8186 with questions about the patient form!
What You Need To Know
Look Into Insurance
Are we in your network? Tricare, Blue Cross Blue Shield, Health Choice, Oklahoma Health Care Authority-TEFRA are currently in network. Call us to find out what your insurance benefits are!
We are currently accepting Sooner Care for ABA services. An autism diagnosis, prescription or referral and a copy of your child current psychological evaluation/
Important Note: Each insurance company has its own unique protocols!
Do you have a prescription from an Oklahoma Physician?
If not, make an appointment and discuss your concerns and why you feel that your child needs therapy.
Your concerns and child’s visit needs to be documented. A copy of the visit (patient notes) and a prescription is required for Sooner Care, TEFFRA, and Oklahoma State funding.
Many other insurances do not require patient notes, although a prescription is required.
What To Expect?
You will observe your child as they get to know the therapist
They will be asked to complete some activities and standardized testing if possible.
Some evaluations could take up to two hours to complete.
Please bring with you child’s IEP or IFSP if they have one.
We are required to have parental or guardian of a child sign a consent to treat, so please attend the evaluation appointment with your child.
Our clinic’s goal is to not to have you and your child wait more than two weeks to get an evaluation appointment.