Roots and Wings — Waitlist for Ongoing OT
Thank you for your interest in Roots and Wings! Please fill this out this form as accurately as possible to ensure your spot on our waitlist for ongoing 1:1 occupational therapy.

Because we see clients in their preferred community settings, we regularly consult our waitlist for those who have matches to therapist availability based on time and geography.

Please note that Roots and Wings is not in network with all insurances. We encourage you to check with your insurance provider to learn whether our OT services are covered and ask if any co-insurance fees will apply. Private payment options are also available.

If you have any questions, please email sandy@rootsandwingsmn.com or call/text 612-314-5286. 

To schedule a personalized neurodivergence training, please use this form: Request a Roots and Wings Training
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Email *
Your name:  *
Your phone number *
Name of individual seeking OT services (if different from above): 
Who is seeking ongoing OT services? *
Which of our services are you interested in? Check all that apply. *
Required
Roots and Wings seeks to be an affirming provider of medical services. Our team of clinicians are committed to serving historically underserved populations, such as those who identify as neurodivergent, LGBTQ+, or a racial minority in Minnesota. 

If you wish to share details about your identity, please do so below.
What are the primary concerns and/or goals you are seeking OT services for?
Your current home address: *
We are currently in network with a growing number of providers listed below. Please select your insurance provider. *
What time(s) are you available for OT services on a regular basis?
Please select all that apply
Morning (8-11)
Midday (11-2)
Afternoon (2-5)
Evening (5 and after)
Monday
Tuesday
Wednesday
Thursday
Friday
Please specify your typical availability (ex: 7 - 9 AM, only after 3 PM, etc.). 
Are you available for Telehealth, in-person, or either? 

Please note that our first TWO sessions are always Telehealth.
 *
Required
Where do you prefer to have services? Check all that apply. *
Required
Are you currently receiving OT services elsewhere (excluding school district services)? 
Clear selection
What is your preferred mode of communication?
Do you require any reasonable accommodations to access our services? *
Is there anything else you would like us to know?
How did you hear about us?
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If you were referred by a professional, who referred you to us?
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