INFORMED CONSENT FOR OCCUPATIONAL, SPEECH, PHYSICAL AND ABA THERAPY
hereby request and consent to LITTLE TESLA PEDIATRIC THERAPY, LLC to perform treatment and care for my child as prescribed by a physician and/or recommended by all treating therapist.I understand and am informed that, as in the practice of medicine, all therapies may have some risks. I understand that I have the right to ask about these risks and have any questions answered about my child's condition, prior to treatment.I acknowledge and agree that a parent or legal guardian must be present during each treatment session.I have carefully read and fully understand this Informed Consent Form and have had the opportunity to discuss it with the treating therapist.I consent and authorize LITTLE TESLA PEDIATRIC THERAPY, LLC to administer treatment under the direction and supervision of a registered physical, occupational, speech, ABA therapist and the assistants if applicable.
