Pediatric Therapy Specialties

Pediatric Therapy SpecialtiesPediatric Therapy SpecialtiesPediatric Therapy Specialties

Pediatric Therapy Specialties

Pediatric Therapy SpecialtiesPediatric Therapy SpecialtiesPediatric Therapy Specialties
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referral form

Physician Referral Form (pdf)Download

Intake forms

Please complete these forms before your initial evaluation.  Please email, fax, or print to bring these documents in to your scheduled appointment.

Combined_Intake_Forms_To_Sign (pdf)Download

Waiver Information

Below are informational links regarding the Bureau of Developmental Disabilities Services, as well as the Family Support Waiver and Aged & Disabled Medicaid Waiver. 

BDDS Services (pdf)Download
Family Support Fact Sheet (pdf)Download
Family Support Waiver Checklist (pdf)Download
Aged and Disabled Medicaid Waiver Fact Sheet (pdf)Download

Crisis numbers

 Emergency: 911
Suicide & Crisis Lifeline: Call or text 988
National Domestic Violence Hotline: 1-800-799-7233
Crisis Text Line: Text "DESERVE" TO 741-741
Lifeline Crisis Chat (Online live messaging): https://988lifeline.org/chat
Self-Harm Hotline: 1-800-DONT CUT (1-800-366-8288)
Essential local and community services: 211, https://www.211.org/
Planned Parenthood Hotline: 1-800-230-PLAN (7526)
American Association of Poison Control Centers: 1-800-222-1222
National Council on Alcoholism & Drug Dependency Hope Line: 1-800-622-2255
National Crisis Line - Anorexia and Bulimia: 1-800-233-4357
LGBT Hotline: 1-888-843-4564
TREVOR Crisis Hotline: 1-866-488-7386
AIDS Crisis Line: 1-800-221-7044
Veterans Crisis Line: https://www.veteranscrisisline.net
TransLifeline: https://www.translifeline.org - 877-565-8860

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Pediatric Therapy Specialties

675 3rd Avenue, Jasper, Indiana 47546, United States

Hours/Contact Us

Open today

08:00 – 17:00

Phone Number: 812-351-1490

Fax Number: 812-301-1329

Email: schillingmelissa@pts-jasper.com



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