Oklahoma City
Home Health Therapy
Services

Tulsa Sunshine Center, a leading pediatric therapy provider in Northeast Oklahoma also provides therapy home services to the Oklahoma City Metro Area. We have multiple speech therapists in the Oklahoma City area that are available for immediate home visit services.

If you are needing immediate Speech-Language Therapy services, please call the office at 918-615-6492 or 1-800-580-6499. The scheduleing specialist will then contact our various therapists in Oklahoma City and find the best fit for your child.

If you would like to join the waiting list for at home Pediatric Occupational, Physical, or Counseling therapy services, then please fill out the form below and we will contact you as soon as we locate qualified therapist(s). Most insurance plans are accepted.

Date  05/20/2012
Therapy Requested
 Occupational Therapy Eval & Treat  Dietician Services
 Physical Therapy Eval & Treat  Licensed Professional Counseling
 Speech & Language Therapy Eval & Treat
Language
 English  Spanish  Other
Client Information
Patient Name:
Date of Birth (mm/dd/yr):
Sex: Male Female
Parent/Guardian Name (If Applicable):
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
Email Address:
How did you hear about us:
Physician Information
Primary Care Physician:
Physician Phone:
Physician Fax:
Clinic Address:
Medical History
Diagnosis (Purpose of Visit):
Has patient been evaluated with the past year?    Yes No
Date of last evaluation:   
Insurance Information
Primary Insurance
Member ID:
Member Name on Card:
Secondary Insurance
Member ID:
Member Name on Card: