Occupational Therapy Interest form

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We are so excited to announce that Play Way Pediatrics Occupational Therapy, a local OT practice, has partnered with Holland Speech to provide occupational therapy services at our Coppell clinic location. Molly Hendrix is a dedicated OT that has a huge heart for children and families. OT services are available including screenings, evaluations, and individual sessions. Holland is excited to welcome Molly's expertise through her service offerings at our clinic. We look forward to also consulting with her and being able to collaborate through co-treating as well.

Please complete this form to note your interest in OT services at the Holland Coppell clinic. Molly Hendrix will then contact you to answer any questions and discuss possible services for your child.

Email *

Record my email address with my response

Child's Name *

Parent's Name *

Child's date of birth *

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Child's Age and Grade *

Parent's email *

Parent's phone number *

Scheduling preferences *

Is your child currently receiving OT services or has your child received OT services in the past? *

Any additional info you'd like to share

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