Nationally ranked care. Another way our love for kids just keeps on growing.

New patient referral process 

How do we get started?

  1. Your child’s primary care doctor makes a referral using our Physician Referral Form. This is available through EPIC and is also posted on this website.
  2. Your family is contacted by Knights of Columbus staff to confirm the referral and to schedule an appointment.
  3. You receive confirmation of the appointment by mail, as well as additional forms to complete. You will also receive a list of suggestions to consider while you wait for your appointment to take place.

What comes next?

  1. Ask your child’s teacher or therapist to complete the Teacher/Therapist packet (about one month prior to the appointment) and return it to you. This form will be sent to you by mail, however, it is also available here.
  2. Complete any other forms that you receive from our center. Bring all completed forms with you to the appointment.

What can we expect?

  1. You and your child will come for your first appointment! Plan to bring completed forms with you. This should include:
    1. Parent Intake packet
    2. Teacher/Therapist packet
    3. Copies of recent evaluations and/or IEPS from school
  2. This first appointment can last up to three hours.
  3. If possible, we recommend two adults be present for the appointment.
  4. We suggest you bring small toys, blankets, snacks or books to keep your child comfortable.

Accessing paperwork

To be evaluated for treatment, each child needs to have the following paper work submitted. Click the links to open, download, fill out and save the PDF forms.

  1. Physician Referral Form 
    To be filled out by the pediatrician’s office and returned by fax 314-268-4028.
  2. Teacher/Therapist Packet
    To be filled out by your child’s teacher if your child is of school age, or by their therapist (OT, PT, SLP or Developmental) approximately one month before the appointment. Bring this completed form to your appointment.

What can I do while I wait for evaluation?

Early intervention is important and we understand the urgency you may feel to have your child evaluated. Here are some resources to consider while you wait for your upcoming evaluation.

For children under age 3:

Consider enrolling your child with Parents As Teachers by contacting your local school district. Contact your local early intervention program:

  • St. Louis: First Steps 314-435-9203
  • Missouri: First Steps 866-583-2392
  • Illinois: Child and Family Connections 1-800-323-4769

For children over age 3:

Contact the Special Education Program of your local school District.


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