How Do I Get Started?
If you are interested in scheduling an evaluation for your child, call our office to get started today! Below are all our new referrals forms.
Greenville office: (252) 341-9944
New Bern office: (252) 341-9944 (EXT. 2)
Goldsboro office: (252) 814-8044
Our office staff will take all of your health insurance information and complete any authorizations or referrals that you may need. Once you have scheduled an appointment, please read over and fill out the following forms. You may email, mail or fax the completed forms prior to your child’s first visit.
Email completed forms HERE
Fax completed forms to (252) 439-0957
Mail completed forms to: 1925 Turnbury Dr., Greenville, NC 27858
COPYRIGHT NOTICE
© 2021 Carolina Therapy Connection | All Rights Reserved
No content displayed on this page or site may be reproduced, distributed, or commercially exploited and is only to be used for fair purposes, as defined in the Copyright Act 1968, without the express written permission of Carolina Therapy Connection. Failure to comply is an infringement of the Copyright Act and its amendments, and may be subject to legal action.
Consent & Information Forms
Consent and Authorization to Treat
Notice of Privacy Practices
Client Rights
Sensory Gym Policies and Procedures and Consent
HIPAA Photo and Video Consent Form
Photo Release Form
Email/Text Form
Teletherapy Consent Form
COVID-19 Consent Form
Formularios de admisión en español
Physician Referrals
For physicians wanting to make a referral for Occupational, Speech, or Physical Therapy services in Greenville, Goldsboro, or New Bern, please fill out the Insurance/Referral Form to the best of your ability and fax to (252) 439-0957.
Trillium Referrals
For Care Coordinators wanting to make a referral for Specialized Consultative Services, please fill out the following forms and email them here.
Referral Form
Consent and Authorization to Treat
Notice of Privacy Practice 2018
Client Rights
Serving Eastern North Carolina with Physical Locations in Greenville, Goldsboro and New Bern
We offer Pediatric Occupational, Physical, Speech therapy services as well as Educational Services in our state-of-the-art sensory integration clinics. We also serve children within the community, daycare, and home settings.
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Our Hours: Monday-Friday: 8am-6pm
Greenville Clinic
1925 Turnbury Dr
Greenville, NC 27858
Phone: (252) 341-9944
Fax: (252) 439-0957
Goldsboro Clinic
697 Community Dr
Goldsboro, NC 27530
Phone: (252) 341-9944
Fax: (252) 439-0957
New Bern Clinic
1314 Commerce Dr, Unit B
New Bern, NC 28562
Phone: (252) 341-9944
Fax: (252) 439-0957