Please fill out the inquiry form below to be added to the Occupational Therapy Waitlist. We are unable to provide an approximate wait time at this moment. Name * First Name Last Name Child's Name * First Name Last Name Child's Date of Birth or Due Date if inquiring pre-birth * MM DD YYYY Phone * (###) ### #### Email * What city do you live in? * Does your child have a current diagnosis (e.g. Autism Spectrum Disorder, language delay, Down Syndrome, etc.)? * Please indicate the areas of concern you are looking for an occupational therapist to support for your child? * Is there any additional information you feel that we should know? * Thank you for your inquiry!You have been added to the waitlist.You will be contacted by The Village YXE admin when an appointment comes available.