Sign Up For Inspiring Little Minds

This form starts the process of enrolling your child in the Inspiring Little Minds program. All fields are required so that we can provide the best service for your child.

If you have any problems with the form or want to sign up multiple children, feel free to contact us at admin@mci-ot.com or 401-682-8063.

Group Location

East Providence

North Kingstown

Parent/Guardian Name

First Name

Last Name

Child's Legal Name

First Name

Last Name

Email

Phone

(###)

###

####

Child's Date of Birth

MM

DD

YYYY

Please provide any relevant information regarding your child's development, challenges you are currently navigating, or medical history. Additionally, please let us know if they are currently receiving any services such as OT, Speech, or PT.

Child's health insurance provider:

Inspiring Little Minds

Sign Up For Inspiring Little Minds

Convenient Hours

Locations