Intake application

Let's get to know your child

Filling out a form can feel like a big step. This one is simply how we start to learn about your child and your family, so the first conversation is about them, not paperwork. Take your time. We're here if you get stuck.

  • Six short stepsBasic details about your child, your family, and your insurance.
  • Private and secureYour information is sent through a HIPAA-compliant form and only seen by our team.
  • Helpful to have nearbyYour insurance card and your child's diagnosis paperwork, if you have it.

What happens next

  1. You send the form. It takes a few minutes, and you can ask us for help anytime.
  2. We reach out. Someone from our team will call or email you to talk through next steps.
  3. We check your benefits. We'll help you understand what your insurance covers before anything starts.
  4. We meet your child. Together, we plan care that fits your child and your family.

Not ready for the form yet? That's okay. A free consult is a relaxed conversation about your child, with no commitment.

Schedule a free consult →

Secure intake formHIPAA-compliant. Only the MBS team sees your answers.