Child Intake Form

If you have questions, contact Andrea Stoker by e-mail or by phone (303) 221-STAR (7827).

Please be aware of our updated guidelines and policies due to COVID-19.

For individuals ages 0-17 years please fill out the Intake Form below to begin the process for your free intake session. If you are an adult seeking a consultation or treatment please fill out the Adult Consultation Form.

We need detailed information about your family and child’s medical and neurodevelopmental history to best understand and help your child. This information is a crucial part of your evaluation process.

We look forward to receiving your information and will be touch within 2 business days after your form is received.

Thank you in advance for your time!

We look forward to meeting you!

— Lucy Jane Miller PhD, OTR, Founder