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How To Register

To complete your registration you will need a username and password. This ensures that your data is secure, and it also allows you to save and return at a later time. Once you complete your registration information, a Heartspring Service Coordinator will be in contact with you to discuss scheduling options. Please feel free to contact us with specific questions. A physician order will be required prior to your initial evaluation to oversee your therapy interventions. Most therapies require an authorization for weekly therapy. Heartspring will obtain these documents for you but may require your assistance to ensure documentation from your primary care physician is received in a timely manner.

Please have the following information available when completing your registration to ensure you can thoroughly complete the information: Employer information, Insurance information, Physician contact information, Specialty physician contact information, child’s developmental history.

Outpatient Forms

Heartspring Pediatric Services now has much of its patient paperwork available online. To fill out any of these forms, you will need to have a Heartspring account. This ensures that your data is secure, and it also allows you to save forms that are in progress and return to them at a later time.

To continue working on an existing form or to begin a new one, please click on one of the links on the right.

Free Developmental Screening

Heartspring Pediatric Services provides free developmental screening for children ages birth to 5 years old. Please click the Free Developmental Screening button to the right,and complete the following information to request a screening of your child’s communication, fine motor coordination, gross motor coordination, personal-social abilities and problem solving. Screening is an effective way to determine developmental progress in children and identify appropriate early intervention when needed.


Pediatric Services Registration
Hearing Center Registration


Free Developmental Screening
Financial Assistance
Existing Patient Renewal

For security purposes, login is required for all forms except development screening requests. You will be directed to the login page if you are not currently logged in. If this is your first time registering on the Heartspring site, please select "Create an Account" to setup a new account and login information.


Of parents/guardians agreed:

  • It was important that my child have an initial evaluation
  • I understand the provider's recommendations I received during the initial evaluation
  • The provider addressed my family concern(s)/child's need(s)
  • Overall, my experience with Heartspring's campus was positive
  • Overall, my experience with the Heartspring business office staff was positive


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