aMAYZingkids Pediatric Therapy in Rancho Santa Margarita, CA

Our Therapy Makes a Difference!

Rancho Santa Margarita, CA - 949-600-5437 - FREE CONSULTATION

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Forms

Please complete and send in forms 48 hrs before your appointment so your therapist can best prepare for your child.

 

STEP 1.   Please complete intake & consent for ALL new patient appointments:

Online fillable New Patient Intake and Consents: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=19604 

Or use this printable form: New Patient Form 

New Patient information Video

STEP 2.   Please complete one of the following pre-exam forms for EACH Specialist that your child will see:

*SPEECH Online fillable Pre-Exam Form:  https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12103 

(Or use this printable form: Speech & Language  )

*OT FEEDING Online fillable Pre-Exam Form: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12115 

(Or use these printable forms: OT- Feeding & Oral Motor         Three Day Diet History  )

*OT FINE Motor/Sensory Online fillable Pre-exam form:  https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12122

(Or use this printable form: OT – Handwriting &  Sensory   )

*PT (Developmental/Torticollis/Gross Motor:  Online fillable Pre-Exam Form for PT : https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12105

(Or use this printable form: PT – Developmental/Torticollis & Gross Motor )

*PT Injury/Orthopaedic care: Online fillable Pre-Exam form:    https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12023

                            (Or use this printable form: PT-Injury/Orthopaedic )

STEP 3.  If you are using CalOptima insurance, and your child is 3 yrs or older, please complete this form:

IEP Notice:   https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12120

Financial Assistance:

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Scholarship Application

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Learn More About Hailey

Learn more about Hailey Mayz and how she has inspired the legacy of aMAYZing Kids through her mother's perspective 

Read Her Blog

29811 Santa Margarita Pkwy #600 Rancho Santa Margarita, CA 92688

The Hailey Mayz Foundation

Honoring the memory of Hailey Mayz Vassilaros July 20, 2006 - August 11, 2009  Her Life She was a little girl—a bright, shine-like-the-sun little girl, born to a regular mom and dad. Her name was Hailey Mayz Vassilaros, and she was born with a challenge. In simple terms, she was born too small … Learn More...

Our Team

These aMAYZing people are the engine of aMAYZing Kids. They are the visionaries who manifest the legacy of Hailey Mayz in their work with children each day. Leadership Stephanie Coe, OTR/L, SWC, PAM, … More

Get Involved

Support the aMAYZing Kids clinic by participating in a Hailey Mayz Foundation fundraising event. … Get Involved

Copyright © 2023 aMAYZing Kids - 29811 Santa Margarita Pkwy #600, Ranch Santa Margarita, CA 92688 • 949-600-KIDS (5437)

Mailing Address: 22431 Antonio Parkway Suite B160-493, Rancho Santa Margarita, CA 92688

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