Welcome Packet - Clinic-PlayRx

Welcome Packet - Clinic

We are so excited to become a part of your child's growth and development! Please read through this packet and provide attestation through initials and signatures where indicated.

Our ST, OT, and PT departments work as teams. This means that your child might sometimes be seen by a different therapist as we shift to cover any therapist absences or scheduling conflicts.

You will receive an invite to Fusion Parent Portal where you can log in and see appointments and review Evaluation Reports.

PlayRx uses BloomText to send secure chat links right to a text thread or email. No need to download an app, just click the link sent to be connected directly to your child's therapist.

PlayRx Contact Information:

Owner: Sarah Clark, Occupational Therapist

Clinical Coordinator: Brenna Kelley, Occupational Therapist

Phone: (501) 819-0553

Fax: (501) 819-0518

Text Line: (501) 391-1922 **If your current BloomText link expires, please text this number**

Email: office@playrxtherapy.com

First Name

Last Name

Your child’s name

PlayRx - Attendance and Communication Policy - Outpatient Clinic

PlayRx's outpatient clinic was opened to provide access to quality, convenient, and efficient services to our patient populations that do not attend daycares within our coverage radius. We work very hard to schedule for each family's availability. In return, we are asking that our clinic patients provide attestation to the following Attendance and Communication policies for Outpatient Services: *please initial each of the following:

I will provide any and all items that my child might need during therapy: diapers, wipes, extra clothes, *an epi pen or inhaler if one is prescribed*, snacks if allergies exist, cup and any modifications required (thickener, etc).

I will confirm clinic times sent by clinic scheduler through Bloom Text.

If advanced scheduled times do not work, I will adjust with clinic schedular prior to week of scheduled times.

I will alert PlayRx within 24 hours of need to cancel advance scheduled appointment. *Exclusions to 24-hour rule: sickness, COVID quarantine, injury, accident.

Upon cancelling, I will immediately reschedule for same week, if a compatible time slot is available.

I understand that 2 consecutive weeks of cancelling without successful rescheduling the same week, could potentially cause loss of preferred scheduling slot.

I understand that 2 consecutive no call/no shows will remove my child from clinic scheduling.

I will arrive for my child's scheduled appointment at least 10 minutes before scheduled time.

I will notify PlayRx clinic scheduler, prior to scheduled time, if I will arrive more than 5 minutes late.

I understand that not being on time will possibly reduce the length of my child's session. (This will be communicated by the treating therapist.)

I will alert PlayRx to any change in Medical Status of my child: Change in PCP, addition of Medical Diagnoses, any change in medications, addition of specialty providers, medical reports: swallow study, hearing/psych/educational/allergy tests, etc.

I will alert PlayRx of any change in my contact information.

Representative of Patient Signature

Date

Authorized Pick Up/Drop Off List

Please list the following for all individuals you would like to be allowed to pick up or drop off your child to their clinic appointment: Name, Relation, Car Make and Model

PlayRx Media Release

Child's Name:

I GRANT permission for PlayRx to publish pictures/videos of my child recieving therapy services for use in printed materials and social media. I acknowledge that I am not receiving compensation, monetary or other, for giving this permission.

Agree. I GRANT permission.

Disagree. I DO NOT grant permission.

Parent/Guardian name

Signature of Parent/Legal Guardian