Get Scheduled with Us at Infinity

Please complete this form to help us understand how we can best assist you. This will ensure your time with us is as valuable and focused as possible.

First Name *

Last Name *

Phone *

Email *

Your City *

Who is this inquiry for? *

My child

Myself

Another family member

Your Child's Name *

Patient's Age *

What are the primary challenges you are seeking help with? (Select all that apply) *

Developmental delays
Autism
ADHD
Speech issues
Primitive reflexes
Cerebral palsy
Behavioral issues
Brain injury
Neurological issues
Genetic Mutations
Other
No elements found. Consider changing the search query.
List is empty.

Which Infinity location are you interested in visiting? *

Des Moines IA (Main Clinic)
Minneapolis MN
Denver CO
Unsure
No elements found. Consider changing the search query.
List is empty.

When would you like to begin? *

As soon as possible

In the next 1-3 months

In 6 months or more

Next year

Are you interested in an intensive therapy program (1 week, $5,000+ investment)? *

Yes

Not sure yet, I’d like more information

We understand this is a significant investment in your health. Are you prepared for the financial commitment for intensive therapy? *

Yes, I am prepared

No, but I’d like to explore financing options

Not yet, I’d like to learn more about other resources

Have you reviewed our website or online resources? *

Yes

No, I’d like the link to learn more

How did you hear about Infinity? *

Instagram
Youtube
Facebook
Tiktok
Online search
Friend/Family
Referral from doctor/practitioner
Other
No elements found. Consider changing the search query.
List is empty.

What specific questions do you have for us?

I Consent to Receive SMS Notifications, Alerts & Occasional Educational Communication from Infinity.