Sign-up

Please fill the form below to enroll to our program Therapy@School. As the name implies, we offer to come to your school, to provide physical and ABA therapy to children who may need it. Your only committment will be to make a room available for our therapist.

Note: Fields marked with an asterisk(*) are mandatory.

School & Contact Information

School name*:

School type*:

  Private school Public school

Contact name*:

E-mail address*:

Phone number:

School Address

Note: For now, we are only able to serve schools in Broward, Palm Beach, and Miami-Dade counties.

Street address*:

City*:

Zip code*:

FL  

State*:

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Login Information

Note: Password must be between 4 and 20 alphanumerical characters, special characters are prohibited except underscore, dash, and dot.

Your password*:

Confirm password*: