Food Range Diary

Office Location(Required)

Please select your correct location.

Child's First Name(Required)

Child's Last Name(Required)

Email Address(Required)

Child's Date of Birth(Required)

Directions: List all of the foods that your child will eat at least 2-3 bites each time that they are served that food (at least 75% of the time that it is offered). List foods by their individual names and be specific. Also include what your child drinks.

Protein-based Foods(Required)

Starch-based Foods(Required)

Fruits & Vegetables(Required)

Anything else, please list and describe:

Today's Date(Required)

READY FOR A FUN THERAPY ENVIRONMENT,
THAT TRULY CARES ABOUT YOUR CHILD AND YOUR FAMILY?

If you are interested in enrolling your child in the intensive strengthening program at PTS, please utilize the links below to complete the intake documents. Once your intake documents are received, you will receive a phone call to screen your child for the program as well as discuss scheduling. If you have any questions, please call (813) 662-1060.