MJ Kidz OT Services Intake
Confirm pricing, timeline, and location, then submit your details to request OT scheduling.
MJ Kidz is launching Occupational Therapy services! We're collecting preliminary information from interested families to confirm location, pricing, and timeline. Once submitted, our team will reach out in early September to schedule your evaluation.
Parent/Guardian Full Name
*
Child's Full Name
*
Child's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you a current MJ Kidz patient/family?
*
Yes
No
What skills are you hoping to address with OT?
Fine motor skills
Gross motor skills
Handwriting
Self-care/dressing
Feeding/mealtime skills
Sensory processing
Visual-motor/visual perceptual skills
Emotional regulation
Other (please specify)
Preferred MJ Kidz Location
*
Marlton
Swedesboro
Collingswood
What timeframes are you able to commit to?
*
Weekday Morning
Weekday Early Afternoon (1:00-4:00)
Weekday Evening (4:00-7:00)
Saturday Morning
Other
OT Evaluation:
$200 |
OT Treatment Session (30 minutes):
$75
Services are expected to begin mid-September 2026.
I understand and agree to the pricing above ($200 evaluation, $75 per 30-minute session) and the mid-September 2026 start timeline.
*
I agree
Anything else we should know?
Submit
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