Leaps & Bounds Registration

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

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Medical Information

Family Goals