Kids In Motion provides various therapy modalities including physical, pediatric, speech and language and home therapies in southeastern Michigan.

Please view all of our available forms below. Our staff may instruct you to obtain and complete our forms and our goal is to have them readily available to save you time at your appointment.

Please note that all our documents available here are in PDF format. You will need Adobe Reader® in order to view these documents. Adobe Reader® is a free download, perfectly safe and available by clicking here. (New window will open.)

	KIDS IN MOTION INSURANCE INFORMATION Please read FIRST.
	SIZE: 25k

	KIDS IN MOTION 2008 PAYMENT POLICY Please read.
	SIZE: 49k

	PATIENT REGISTRATION FORM Complete online, print, sign and BRING to your appointment.
	SIZE: 160K

	PATIENT RIGHTS & RESPONSIBILITIES Print, complete, sign and BRING to your appointment.
	SIZE: 37k

	AUTHORIZATION FOR TREATMENT ****Complete online, print, sign and BRING to your appointment.
	SIZE: 45k

	PHOTO PERMISSION AUTHORIZATION FORM ****Print, complete, sign and BRING to your appointment.
	SIZE: 33K

	PAYMENT VERIFICATION Complete online, print, sign and BRING to your appointment.
	SIZE: 48k

	DEBIT WITHDRAWAL AUTHORIZATION Complete online, print, sign and BRING to your appointment.
	SIZE: 130k

	MEDICATION LOG Print, complete and BRING to your appointment.
	SIZE: 33k

	KIDS IN MOTION RATES FOR 2008 Please read.
	SIZE: 29k

	INSURANCE COMPANY TIPS Please read.
	SIZE: 41k

	CLINIC RULES Please read.
	SIZE: 33k

	HIPAA INFORMATION Please read.
	SIZE: 459k

	HIPAA ACKNOWLEDGEMENT FORM ****Print, complete, sign and BRING to your appointment.
	SIZE: 33k

	COMMUNICATION LOG WITH DIRECTIONS (FOR HOME PATIENTS) Print for your use at home.
	SIZE: 24k