Ready to Get Started?

Brighton Center’s Pediatric Therapy Clinic provides speech, occupational, and physical therapy for children ages 3–6. Our licensed therapists work with your family to support your child’s communication, movement, and daily skills during these important early years. Completing this form is the first step toward personalized care for your child.

Here's what to expect:

✔ A member of our team will reach out within 2 business days

✔ We will review our services, discus your child's needs and your insurance information.

Let's start your child's progress today!

Child First Name *

Child Last Name *

Child Date of Birth *

Guardian First Name *

Guardian Last Name *

Guardian Phone *

Guardian Email *

Address *

City *

State *

Postal code *

Did you receive pediatric therapy from Brighton Center's ECI Program *

Yes

How did you hear about Brighton Center's Pediatric Therapy *

Reason for Referral *

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