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  • Home
  • Services
    • Therapy
    • Social Group/Classes
    • Intensives
    • Camp Kid Power
    • Insurance
  • Parent Resources
    • What to do During a Tantrum?
    • Parenting in the 21st Century
    • Downloadable Resources
  • Forms
  • Contact Us
+1 (847) 748-8733

Forms

NEW PATIENT FORMS

Intake (pdf)

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Intake (pdf)

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Photo release (pdf)

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Financial Responsibility (pdf)

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Center Policies (pdf)

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Billing Authorization (pdf)

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HIPAA Policy (pdf)

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HIPAA Policy Client Consent (pdf)

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Kidnectivity
  • 600 Waukegan Road, Ste 132
    Northbrook, Illinois 60062, US

  • +1 (847) 748-8733

  • +1 (847) 739-7164

  • info@kidnectivity.org

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