Please fill out the information below completely and a staff member from Scottish Rite for Children will contact your patient's family/guardian to schedule an appointment and answer any questions. Referrals for dyslexia/learning disorders should be directed to the Center for Dyslexia Application Process section of the Dyslexia page.

Note: If you are a parent or guardian of a patient, please complete the Patient Online Appointment Request.

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Referring Provider Information

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Practice Information

   


   


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Patient Information

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Parent / Guardian Information

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Appointment Information

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