Request Therapy
Both parents and physicians can request therapy services through our referral form. If you or someone you know is looking for therapy, please click the button below to submit a request for therapy services.



Request New Patient Intake

NEW Elite Therapy Center clients need to fill out a New Patient Intake Form. This is NOT an online document. You must click to request this PDF document from our administrative team.  When finished, please click the email button at the top of the Acrobat program and email to: kim.kennedy@elitetherapycenter.org

SAMPLE BELOW:Elite Therapy Center New Patient Intake Form

** Regulations require that forms must be signed and authorized with a witness signature. We will verify this upon your visit.

 



>> Elite Therapy Attendance Policy

 



>> Sick Policy

It is the policy of Elite Therapy Center that in the event the patient becomes ill, Elite Therapy Center will utilize the following guidelines for re-admitting patients into treatments as listed below:

Cancel appointment if no one or more of these conditions are present:

  • Oral temperature of 100 degrees or above
  • Vomiting, nausea or severe abdominal pain
  • Marked drowsiness or malaise
  • Sore throat, acute cold, or persistent cough
  • Red, inflamed, or discharging eyes
  • Acute skin rashes or eruptions
  • Swollen glands around jaws, ears and neck
  • Suspected scabies or impetigo
  • Any skin lesion in the weeping stage
  • Earache
  • Pediculosis (head lice)
  • Diarrhea: runny, watery or bloody
  • Other symptoms suggestive of acute illness

Return to Therapy Guidelines:

  • Fever free for full 24 hours
  • Symptom free of vomiting, nausea or severe abdominal pain
  • Symptom free of marked drowsiness or malaise
  • Symptom free of sore throat, acute cold, or persistent cough
  • Treated pediculosiis (head lice)
  • Symptom free diarrhea: runny, watery or bloody
  • All health conditions listed above have been treated and resolved