2024 Summer Camp 
Little Hands - Intake Form (Occupational Therapy)

Save & Return

Login to complete a saved intake form or create an account in order to save and return to your intake form.

2024 Summer Camp

Sign ups & Payment Due by May 10th at 11:30pm
* please inquire if your child is out of the age range but the intensive seems like it would be a good fit!

Summer Therapy Intensive Camps:

  1. Self-Regulation/Social Skills (ages 6-10)
  2. Self-Regulation/Social Skills (ages 3-5)
  3. Let's Get Organized (ages 7-10)
  4. Kindergarten Buddies (Preschool and Kindergartners)
  5. Courageous Kids (ages 4-7)

Child's Information


Parent Information

Parent 1 (Required)
Parent 2 (If Applicable)
Secured by Formsite


Gabrielle Perelmuter, MOT OTR/L
Clinical Director & Occupational Therapist

(415) 531-3027

Little Hands
500 Tamal Plaza, Suite 505
Corte Madera, CA 9492