Client Forms

All client forms are submitted directly to you through TherapyPortal Access once you have scheduled an initial evaluation with your therapist. TherapyPortal Access is a secure and HIPAA compliant platform to complete forms electronically and communicate with your therapist.

We encourage you to complete these forms ahead of time to avoid having to complete documents at the time of your appointment (this can take up time which is valuable to you during your first appointment). If you do wish to complete paper documents, please arrive 15 minutes early to your appointment.

Provider Referrals

If you are a provider seeking services for you client(s), please complete our Provider Referral Form below. You can fax completed forms to 515-420-8303. Referral forms which are not fully completed will not be responded to. The Heart of Play, LLC reserves the right to deny a referral for lack of information and/or if our therapists are not an appropriate fit. The Heart of Play, LLC reviews all referrals to determine and ensure goodness-of-fit for services.

Provider Referral Form

All forms belong to The Heart of Play, LLC and not your individual therapist. The Heart of Play, LLC is the owner of all documents. Should you need a records request, please contact The Heart of Play, LLC at 307-274-8705.