Fall 2025 pop-up Registration

Winter 2025 Pop-Up Intensive Registration

December 1-5, 2025
Haven Kids Therapy is excited to offer a pop-up mini intensive this fall!

We are partnering with Love Your Story and Wild Heart Therapy for this event for a retreat-style, family focused experience.
- 2 hours per day of DMI intensive therapy
- Family/Caregiver group activities Wild Heart Therapy, including arts and equine (horse) assisted experiences
- FREE Housing, snacks, and lunches from our non-profit partners at Love Your Story.
About Us:

Haven Kids practitioners are highly trained in a variety of modalities, such as Dynamic Movement Intervention (DMI), Therasuit methodology, Theratogs, Whole Body Vibration, Neuromuscular Electrical Stimulation, Reflex Integration, Therapeutic Listening protocols, and more.

Erica Autry-Henderson, LMSW with Wild Heart Thearpy is a trauma-focused therapist with various specialities and modalities including EMDR, IFS, Somatic, Expressive Arts, and Equine Assisted therapies.

Complete the form below! We will reach out to submissions to confirm booking and gather more information as needed.
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Caregiver Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
May this email be used for purposes of mailing documentation and/or invoices?*

YesNo
What is your preferred form of communication?*

PhoneTextEmail
What time of day is best to initiate contact?

MorningsMiddayAfternoonEvening
Client Background

Tell us a little bit about your kid!
Diagnosis or reason for seeking intensive therapy services?
What are some goals you are wanting to work towards?
What current therapy services is your child receiving?

OTPTSpeech
We are partnering with Love Your Story for this event to aid families in need of housing during their intensive. This service is free of charge. Will you be needing to utilize Molly's House or other housing services while you are here?*

Yes (I will be directed to complete additional forms as needed for LYS at time of booking)No, we will be commuting
Any questions or concerns?
Completion of this form does not gaurantee placement. Haven Kids Therapy will be contacting you to discuss further details and to confirm participation.

Cost for this program is discounted at a flat rate of $1300. This covers all sessions for both children and caregivers. A $300 deposit will be required at time of official booking. The remainder will be due 7 days prior to the start of the program.

We are able to provide superbills for families who are interested, as well as aid in any grant submission requirements. Portions of this program may be reimbursable from insurance. We can help navigate benefits in this area at time of booking.
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Winter 2025 Pop-Up Intensive Registration

Client Background