Group Programs Registration

If you think your child could benefit from our support and services, send us a message!

Name(Required)

First Last

Email(Required)

Phone(Required)

Concerns

Following directions and answering questions

Communicating (using gestures, words, etc.)

Speaking clearly and being understood

Playing with toys

Using their hands/fine motor skills

Sensory concerns

Emotional regulation

Handwriting

Mental Health

Feeding

Moving around safely and independently/gross motor skill

Other (Explain below)

Your Message

Mailing List Consent

I would like to receive periodic emails and updates from Basal Therapies.

8411 Broadband Drive
Suite C & D
Frederick, MD 21701