Welcome to Kid’s Creek!

Thank you for choosing Kid’s Creek for your child’s treatment needs. In this section, you will find a confidential case history form, our business policy/financial agreement, and our privacy policy. Prior to our first visit we need some additional information from you. Listed below is a checklist of the things that we need from you. You may drop these items off at our office or mail them to us.

Your child’s file must be complete with all items prior to starting therapy.

Getting Started Checklist

  • Prescription from your child’s primary care physician with ICD-9 code and
    frequency of visits
  • Current Evaluation
    If your child has previously received therapy at another facility, we are happy to review those evaluation results to see if supplemental assessment is required or if the results provide adequate information for treatment to begin. Existing speech, occupational or physical therapy evaluations must be less than 12 months old for primary insurance and less than 6 months old for all Medicaid patients.
  • Kid’s Creek Case History FormDownload Case History form (.pdf)
  • Kid’s Creek Privacy PolicyDownload Privacy Policy (.doc)
  • Financial Policy AgreementDownload Agreement (.doc)
  • Insurance Information
    Please copy the front and back of your primary and any secondary insurance
  • Medicaid Information
    A copy of Medicaid card and a copy of the current months eligibility form*
  • Preauthorization
    Please check with your insurance company to see if they require preauthorization **

* Medicaid Information: Traditional Medicaid or Deeming Waiver
** Preauthorization: If preauthorization is required, you will need to go through this process prior to beginning therapy.

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