Getting Started Form

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Radiant Kids Therapy is a speech therapist-owned, San Diego-based company comprised of many excellent, licensed Speech-Language Pathologists, Occupational Therapists, and Physical Therapists. Our highly qualified therapists provide speech, physical and occupational therapy, and assessment services for children from ages 0 to 18.

We serve clients in person throughout San Diego County, all of our in person appointments are in the client's home. We also offer services via teletherapy for families all throughout California.

Please take a moment to fill out this form so that we may better serve you. We will check our availability and get back to you as quickly as possible; typically within 2 business days.

Email *

Your contact information (your name and phone number) *

What type of service(s) are you looking for? (Check as many as apply.) *

Speech Therapy

Occupational Therapy

Physical Therapy

Independent Educational Evaluation (school-funded "IEE") for Speech

Independent Educational Evaluation (school-funded "IEE") for OT

Independent Educational Evaluation (school-funded "IEE") for PT

Required

Your child's first and last name *

Your child's age (if under 2, please include months) *

What are your general concerns regarding your child's developmental skills, or what areas would you like us to address? *

Name of your insurance provider, and insurance type (e.g., TriCare Prime, TriCare Select, Blue Shield PPO, etc.).

Your zip code *

Currently, most of our therapists are providing in-person services and some are providing services via teletherapy -- video call. Please let us know what you'd prefer. (Please note that in-person services are only available throughout San Diego County at this time; telehealth services are available anywhere in California.) *

In-person therapy services

Teletherapy services

Open to either type of therapy; we do not have a preference at this time.

If we do not have a therapist available in your area for in-person services at this time would you like to be added to our waiting list?

Yes

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What is your scheduling availability? Most of our therapists' availability is during typical business hours on weekdays; we occasionally also have evening or weekend availability. The more availability you're able to give, the more likely one of our therapists in your area will have a matching time open. *

Are there any parking fees, metered street parking or other parking restrictions at the location you would prefer for your child to be seen for therapy? If so, please describe. If not, please indicate N/A.
*

How did you hear about us? (Check as many as apply.) *

Google

Other Search Engine (please specify which one next to "Other")

TriCare Provider Search (TriCare Website)

Blue Shield Provider Search (Blue Shield Website)

Doctor's office / medical referral (please specify who next to "Other")

Word of mouth (i.e., friend/ family/ acquaintance; please specify who next to "Other")

Brochure

SpeechTherapyNext.com

Yelp

Facebook

Instagram

Other:

Required

Please note that we cannot share vaccination information about our staff as it is HIPAA-protected health information.

The safety and wellbeing of our staff and the families that they work with is a top priority. Having a vaccine doesn’t prevent someone from carrying or spreading the virus, which is why our safety protocols are the same regardless of vaccination status - following current state and local guidelines. If a therapist is not vaccinated, they are required to show the company proof of a negative COVID test. Once a therapist has connected with your family for services, if they voluntarily offer to share their vaccination status with you, that is their decision. Thank you for your understanding

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