The Client hereby engages the Provider to provide services as described under "Scope and Manner of Services." The Provider hereby agrees to provide the Client with such services in exchange for consideration as described under "Payment for Services Rendered."
Scope and Manner of Services
Pediatric Therapy Bridge LLC agrees to provide the Client with direct, specialized occupational therapy evaluations, treatment sessions with the child, and any related therapeutic services as needed. Services may include, but are not limited to, assessments, interventions, parent education, consultation, home programming, and recommendations to support the child’s functional development and progress.
The Therapist will also be available by phone call, text message, and FaceTime to answer the Client’s questions related to treatment, home programming, and follow-up care.
Payment for Services Rendered
Client shall pay Pediatric Therapy Bridge LLC for services rendered according to the Payment Schedule below, within three (3) calendar days of the invoice date. Payment may be made by credit card or ACH transfer. Parent/Client agrees to register on the Parent Portal and enroll in an active automatic payment (autopay) method prior to the start of services or scheduled sessions.
Client is responsible for cancelling or rescheduling appointments at least twenty-four (24) hours prior to the scheduled appointment time. Failure to provide timely notice will result in a cancellation fee equal to the full session fee. In the event of illness, if the parent notifies the Therapist as soon as possible, the cancellation fee may be waived at the Therapist’s discretion.
Superbills are available through the Parent Portal. Supporting treatment notes will not be available for insurance submission.
Applicable Law
This contract shall be governed by the laws in the State of Florida and any applicable Federal law.
In witness of their agreement to the terms above, the parties or their authorized agents hereby affix their signatures: