Get Started

Get Started

Your Child's Journey Starts Here

Taking the first step can feel overwhelming — but at The LEEAP Center, we make it simple. Our warm, knowledgeable team will guide your family through every step of the enrollment process.

How to Get Started at The LEEAP Center

We've designed our enrollment process to be as smooth and stress-free as possible.

1

Reach Out

Call us at 980-422-5887 or fill out the form below. Our friendly team will respond promptly.

2

Benefits Verification

We'll verify your insurance benefits and walk you through any out-of-pocket costs — no surprises.

3

Comprehensive Evaluation

We'll schedule a thorough evaluation to understand your child's unique strengths, needs, and goals.

4

Therapy Begins!

Your personalized, evidence-based therapy plan is developed with you — and then the real work, and joy, begins.

Client Forms

Client Online Forms

Hello families! To help make your first visit as smooth as possible, we've made our intake forms available online. Completing these forms ahead of time allows us to get to know your child and family before your appointment and helps us use our time together more effectively.

Here's how it works — it's simple!

1

Click a form below

Select the form that applies to your family — English or Spanish intake, consent forms, or HIPAA info.

2

Enter your name & email

You'll be directed to our secure intake platform. Simply enter your name and email address to get started.

3

You're one step closer!

Once completed, you're one step closer to beginning your journey with our team — we're so glad you're here.

Intake Forms

Start here — complete your child's enrollment intake form before your first appointment.

English Intake Form

Required · English

Our primary enrollment intake form. Complete this before your first appointment to help us get to know your child and family.

  • Parent & child information
  • Medical & developmental history
  • Insurance & billing details
  • Reason for referral
Open Form

Spanish Intake Form

Requerido · Español

Formulario de inscripción principal en español. Complételo antes de su primera cita.

  • Información del padre/tutor y del niño
  • Historial médico y de desarrollo
  • Detalles de seguro médico
  • Motivo de la referencia
Open Form

ACT NOW Free Screening Form

Free · No Cost

Request a FREE speech-language or occupational therapy screening for your child through our ACT NOW program.

  • No insurance required
  • Speech-language screening available
  • Occupational therapy screening available
  • Results shared with family same day
Open Form

Consent & Privacy Forms

Required consent and privacy forms that authorize your child's care and protect your family's information.

Telepsychology Consent Form

Required · Virtual Services

Required consent form for families receiving virtual psychology services through The LEEAP Center.

  • Authorizes virtual psychology sessions
  • Outlines telehealth rights & limitations
  • Required before first virtual session
  • HIPAA-compliant platform
Open Form

Consent to Share PHI Form

Consent · English

Authorize The LEEAP Center to share your child's protected health information with designated parties (school, physicians, etc.).

  • Specify who may receive records
  • Define scope of information shared
  • Required for school collaboration
  • Can be revoked at any time
Open Form

HIPAA Information & Privacy Notice

Privacy · English

Review The LEEAP Center's HIPAA privacy practices and understand your rights as a patient.

  • How we use your health information
  • Your rights as a patient
  • How to file a privacy complaint
  • Contact info for privacy questions
Open Form

Parent Resource Information

Resource Guide

Access our comprehensive parent resource guide to support your child's therapy journey at home and in the community.

  • Home practice strategies
  • Community support links
  • Milestone reference guides
  • Insurance & billing FAQs
Open Form

Need help with the forms?

Our team is happy to walk you through any form over the phone. Call us at 980-422-5887 or email [email protected].

Contact Information

We're Here to Help

Our friendly team is ready to answer your questions and help you get started. Don't hesitate to reach out — we'd love to hear from you!

Charlotte Location

8848 Red Oak Blvd, STE AA
Charlotte, NC 28217

Monroe Location

1902 W. Roosevelt Blvd, Suite C
Monroe, NC 28110

Office Hours

Monday – Friday: 9:00 AM – 7:00 PM
Saturday: By Appointment

Insurance We Accept

We are an in-network provider for major insurance plans. View full insurance list →

MedicaidBlueCross BlueShieldAetnaUnited HealthcareTRICARECignaMedCostVA Community Care

Request an Enrollment

Fill out the form below and our team will contact you within 1 business day.

By submitting, you agree to be contacted by The LEEAP Center. We respect your privacy.

FAQ

Frequently Asked Questions