Patient Info / Forms

At PediPlay in Indianapolis, IN, our pediatric therapy team is dedicated to understanding the unique needs of your child and creating a personalized treatment plan to help them enjoy an active and fulfilling childhood. 

How to schedule an evaluation 

  • Referral: Contact your physician for a referral and have it faxed to PediPlay at (317) 791- 9001.
  • Referral Nurse: PediPlay’s referral nurse will reach out to go over all your concerns,  medical history, availability, and will verify that your insurance is in network.
  • Scheduling: Our front office will reach out to schedule your initial evaluation.

 

Here’s a checklist of things you’ll need for your child’s first appointment:

  • Arrival Time: Please arrive 15 minutes early for your child’s initial visit to allow time for  paperwork completion.
  • Documents: Don’t forget to bring essential documents, including your photo ID and your  insurance cards.
  • Insurance Verification: Prior to your appointment, our office obtains a quote of benefits  from your insurance provider.
  • Medical History: Be ready to provide information about your child’s medical history, past  treatments, current medications, and any other relevant details. Prepare a list of questions  or concerns you’d like to discuss during your first meeting with our pediatric therapist  such as your child’s symptoms or limitations, including activities, positions, or movements  that worsen or improve their condition.
  • Scheduling: Before leaving your child’s initial evaluation appointment at PediPlay, you’ll  discuss your availability for ongoing appointments.
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Should you have any further questions or concerns, please don’t hesitate to reach out to us anytime.

Want to Save Time?

Complete Forms in Advance!

To streamline your child’s first visit, consider filling out the necessary forms online or printing the patient forms below. If you opt for printed forms, please arrive at least 15 minutes early to ensure sufficient time for completion before your child’s appointment. 

1New Patient Registration Form

New Patient Registration Form

At PediPlay, our team is committed to supporting you and your little one throughout your child’s treatment journey. 

Get in touch with us today to get started!