Helping Hands Registration

Summer, Fall, & Winter Sessions

View Summer Helping Hands page.
View Winter Helping Hands page.

Privacy is very important to us. No information sent to Intensive Therapeutics will in any way be distributed or shared without your acknowledgement and consent.

Instructions to complete registration forms:

  1. Complete the Contact/Medical information below and submit.
  2. Complete and sign the following two (2) forms:
    Informed Consent Form
    Video/Photo Permission Form
  3. Forms can either be uploaded at the end of this form, mailed to:
    Intensive Therapeutics, Inc.
    31 Fairfield Avenue
    West Caldwell, NJ 07006

    OR emailed to: info@intensivetherapeutics.org
    *Forms must be completed, signed, and received at least one month prior to program start.

Registration Information

First
Last
mm/dd/yyyy
First
Last

Program Information

(Once you select a program, session options will appear.)
Would you like your child to participate in “Pizza Fridays”? *

Medical Information

Family Goals

Consent Forms

Please upload completed Informed Consent and Video/Photo Permission forms here.
Maximum upload size: 104.86MB