Become a Kool Kid

Step 1

Contact us with your referral.

Kool Kidz accepts referrals from:

  • Physicians
  • Early intervention coordinators
  • Other therapists/educators
  • From the family itself

Phone: (770) 643-0868
Email: contactus@koolkidzpt.ydodev.com

Payments Accepted

We accept the following forms of payment:

  • Private Insurance (out of network provider)
  • Blue Cross Blue Shield (in network provider)
  • Private Pay
  • Medicaid
  • Peachcare for Kids
  • Amerigroup CMO
  • Peach State
  • CareSource

Step 2

Submit your info.

We need some support information prior to your first appointment. Please fill out the forms.

1Basic Information
2Insurance & Medical History
3Consent & Checklist

Child's Information

Name(Required)
YYYY dash MM dash DD
Address(Required)

Parent's Information

MM slash DD slash YYYY
MM slash DD slash YYYY

Referring Physician