Welcome to Neurotherapeutic Pediatric Therapies
and thank you for the opportunity to serve you!

For Occupational, Physical and Speech Therapy Services

Please contact our Intake Coordinator at 503-263-8903 or send an email to intakes@nt4kids.org.

Here’s what we will need to schedule an appointment:

  • A prescription (or written referral) from your child’s physician for the evaluation and/or therapy services. Please contact your medical provider directly and request the prescription to be faxed to our office at 503-266-8632. It will need to include a diagnosis AND diagnosis code.
  • Completed paperwork – See below

On the day of your evaluation appointment, check in is 15 minutes before your scheduled appointment time. please bring with you any other relevant reports such as recent therapy evaluations, IEP/IFSP, or mental health evaluations.

For Mental Health and/or Naturopathic Medical Services

Please contact our Mental Health and Medical Care Coordinators, at 503-372-5147 ext. 6 or email to MH.Med@nt4kids.org.

Here’s what we will need to schedule an appointment:

  • Completed paperwork – See below

On the day of your evaluation appointment, check in is 20 minutes before your scheduled appointment time. Please also bring any recent evaluations, mental health services, and developmental services (diagnostic testing, Individualized Education Program (IEP), counseling, therapy) that you may have.

Paperwork

1

ALL SERVICES, please complete the Registration Packet

Registration Packet

Neuro Registration Packet
2

Then, based on the service(s) you are seeking, please complete the additional paperwork indicated in the sections below:

Occupational, Physical & Speech Therapy Services

OT/PT/ST Supplemental Packet

Feeding Services

OT/PT/ST Supplemental Packet
Feeding Services Packet

Mental Health Therapy Services

MENTAL HEALTH Supplemental Packet

Then, select one:

Confidential Info & History ADULT
Confidential Info & History CHILD

Medical Program Services

Medical Program Supplemental Packet

Then, select one:

Confidential Info & History ADULT
Confidential Info & History CHILD
Insurance and Billing

Insurance companies can help cover the cost of our services, and while we are not able to guarantee coverage, we are committed to helping you understand your plan’s benefits and assist in utilizing the existing benefits available. We are in-network with many commercial and state insurance plans and do bill for services provided at our clinics, even if we are out-of-network.

More information about the initial evaluation and answers to frequently asked questions can be found here:

Frequently Asked Questions
Referrals

Thank you to the physicians, professionals, teachers, and friends who refer to our clinic! We consider your referral to be the highest compliment and look forward to the opportunity to care for those you are referring!

If you are a Referring Physician who will also be providing the written referral or prescription for occupational, physical, and/or speech therapy, please fax it to our office in Canby at 503-266-8632.

It will need to include the:

  • client’s name
  • date of birth
  • parent/guardian’s name (if applicable)
  • phone number
  • type of insurance
  • diagnosis and diagnosis code
  • reason for referral
  • physician’s name
  • facility/clinic name
  • contact person
  • phone number

Many referring physicians fax over a “referral form” or chart notes from their EMR program which typically includes the details we need. If it is more helpful to use our Referral Form, we have made one available for you below.

Once we receive your referral, we will contact the client(s) right away to schedule the initial appointment.

OT/PT/ST Physician Referral Form

Complete form and submit to our Canby Clinic

Mental Health/Medical Physician Referral Form

Complete form and submit to our Oregon City Clinic