Are You a Referring Physician?
How to Refer for an Evaluation
Fax the referral/script with the information below to Stride Therapy and Wellness: (314) 833-8848
Script Requirements
Child’s name & date of birth
Caregiver name and contact number
ICD-10 code(s) for any medical diagnoses (if applicable)
f no medical diagnosis, include suspected ICD-10 therapy codes for SLP/OT/PT
“Eval & Treat” statement, specifying the appropriate discipline
Signature of provider