Clinic Child Registration

Prior to scheduling your first service, please download the Registration Form via the button below. Once you have completed and signed the form, please return to this page and send it to us as an attachment via the submission form below. After we receive the form, our office will contact you to set up your service.

Download Child REgistration Form

Child Registration Submission Form

Please submit your Registration Form as an attachment here!

Once you have submitted this form, we will get back in touch with you to schedule your service.

Register your child

Parent or Guardian's First Name*

Parent or Guardian's Last Name*

Phone

Email*

What services are you requesting?

How did you hear about us?*

Attach Registration Form

Attachments (0)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Phone: 984-289-3890

Email: Therapy@carolinaschoolservices.com

Home
for Schools
Clinic Services
Child Registration
Contact Us
Job Board
Student Career Kickstart

PARENTS - Our new therapy clinic is now open!

For more information about our new pediatric therapy clinic in Raleigh...

Click here

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Decline Accept