Donate

Clinical Forms

For Your First Visit

Thank you for choosing High Hopes to meet your child's therapy needs!

Please print and fill out the following clinical patient forms and bring them to your first visit:

  1. 1.) Medical History Form
  2. 2.) Clinical Admissions Packet
  3. 3.) Clinic Parent Handbook

Other Forms if Applicable:
Feeding Evaluation - Food Diary ~ Food Preferences Checklist
Therapy Scholarship Application

  • Upcoming Events

    1. Sky High Sports- Special Jump Time

      May 2 @ 3:00 pm - 6:00 pm
    2. Jump Street- Special Needs Hour

      May 6 @ 9:00 am - 10:00 am
    3. Sensory Friendly Movie- “Guardians of the Galaxy Vol. 2”

      May 6 @ 10:00 am - 11:30 am
    4. Sensory Friendly Performance of “Goodnight Moon”

      May 6 @ 11:00 am - 1:00 pm
    5. FREE Family Festival Day at The Frist

      May 7 @ 1:00 pm - 6:00 pm
    6. Giving on the Green Golf Tournament

      May 8 @ 11:00 am - 6:00 pm
  • Testimonials

    "Teachers & therapists love the work they do"

    Stories of Hope, elleMeet our Elle.  Born in June 2010, Elle was six weeks early and spent almost two weeks in the Neonatal Intensive Care Unit learning to ea...


    Read More Testimonials »

  • Follow Us

  • High Hopes

  • Sign Up for Email Updates

    Your Name (required)

    Your Email (required)

    Your Mailing Address

  • Contact Us