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Inquiry Form

Practitioner referrals and self-referrals are accepted. Please complete the form with the information for the person being referred for OT services. Referrals may be faxed to 218.610.4041.

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All information submitted on this form is completely confidential, secure and encrypted.

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Once the form is completed and submitted

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We will contact the provider indicated on the form to obtain physician orders for OT services. When we obtain the physician's order and verify your insurance, we will reach out to schedule an intake appointment.

Scheduling

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  • If you are interested in beginning OT services - Please complete the referral form (physician and insurance information are necessary) then contact us to book a free 15-minute meet/greet (optional) - if you would like to ensure services are a good fit.

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  • For OT services in Minnesota & Wisconsin, it is required that we have physicians order first before completing an intake/evaluation. Please schedule, 2 weeks in advance to allow time for us to obtain that order. You can then go into the client portal to request an OT evaluation appointment, please know that if we do not get the order we will have to cancel your appointment and reschedule.

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