A waiting room with four gray chairs aligned against a window with white blinds, a white cabinet against a light blue wall with a sign that says 'Your village,' a potted plant on a white stand, and various coffee and refreshment supplies on the cabinet.

Welcome to Your Village!

Interested in working together? We are so excited to support you!

To begin services, please complete our secure New Patient Intake Form below. 

During the intake process, you will: 

  • Complete the new patient intake forms below. (If we have questions or need to respond, we will contact you before next steps)

  • Next, you will receive a patient portal invitation where you will complete required patient registration, intake forms, and upload insurance cards (front and back) if you are planning to use insurance.

  • Upload your physician referral (if applicable) or have your provider fax it to 1-866-342-9573. Referral is required for speech, OT, nutrition, and ABA if utilizing insurance.

  • Put a Payment method on file in the portal with required financial agreement forms 

Once all required documents are received, our team will verify your insurance benefits and contact you to schedule your evaluation. 

Please note: Evaluations are scheduled after intake paperwork, insurance information, and referrals have been received and reviewed. 

Please feel free to call us with any questions or to schedule an appointment at 636-233-8754!