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Therapy Services Request Form

Please complete this form to request any of our therapy services.

We will be in touch within 48 business hours.

Student Observation Requests

Thank you for your interest in observing at Achieve Pediatric Therapy! Due to the high volume of requests to shadow, shadowing opportunities are based on a first come basis for those who fit into our therapists’ availability. We offer a placement for one day with limited potential for other days depending on requests made that month. If you would like to request a placement for observation, please complete the request form and Courtney Dixon, Student Coordinator will contact you.

COVID Policy: For the best interest, health and wellbeing of our clients & staff, we require students who are shadowing to be vaccinated. We understand that you may choose not to be vaccinated. Unfortunately, we will not be able to schedule you.

Contact Us for More Information

Therapy Services Request Form

Achieve Pediatric Therapy Registration

Student Observation Request Form

Student Observation Requests

Testimonial Submission

Submit Testimonial

Contact Us for More Information

Therapy Services Request Form

Achieve Pediatric Therapy Registration

Student Observation Request Form

Student Observation Requests

Testimonial Submission

Submit Testimonial

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