Register Your TheraTogs Product

Purchaser / Caregiver Information

Privacy and Consent*

We guarantee the privacy of any data you provide us. Your information will not be shared, and you’ll receive a confirmation email when you submit this form. You can review our full Privacy Policy here.

I agree to the privacy policy.

Your Relationship to TheraTogs Wearer*

Wearer
Parent / Caregiver
PT
OT
CO / CPO
Other

Caregiver Name*

First Last

Caregiver Email*

Caregiver Address*

This is the address to which we will send our Product Registration thank-you gift!

Street Address Address Line 2 City State ZIP Code

Therapist or Clinician's Name

First Last

Therapist or Clinician's Email

Name of Clinic or Practice

Product Information

These questions pertain to the TheraTogs product you received.

Registration Number*

Please enter the unique Product Registration Number (PRN) that will be found on the outer packaging of your TheraTogs system. If you don't have a PRN, enter today's date in DDMMYYYY format, numbers only.

Date You Received Your TheraTogs

TheraTogs Size & Model Code

Enter the size and model code found on your product package. Example: "GPTA210".

Age of Wearer

Enter in months, or months + years. Examples: "6 mo" or "2 yrs + 3 mo".

Primary Diagnosis or Indication*

Enter the primary diagnosis or indication(s) which this TheraTogs system is intended to address.

Quick Survey

Answers here are optional, but much appreciated!

Is this your first TheraTogs system?

Yes
No

Where/how did you first hear about TheraTogs?

How were your TheraTogs purchased?

Out of pocket / cash pay
Insurance reimbursement
Medicaid / Medicare
Early Intervention program

What Billing Code was used

(If you know, that would be very helpful... this is usually a code like L0456, L1499, or something similar.)

If reimbursed, by which insurance company?

Who were your TheraTogs purchased from?

TheraTogs Seller

Please enter the name of the organization from whom your TheraTogs were purchased, if known.

Register Your TheraTogs Product

Product Registration

Purchaser / Caregiver Information

We guarantee the privacy of any data you provide us. Your information will not be shared, and you’ll receive a confirmation email when you submit this form. You can review our full Privacy Policy here.

Product Information

Quick Survey

Do you have any questions?

Therapy you can wear…

Join Our Mailing List

Facebook Feed

Quick Links

Contact Information

Customer Support

Clinical Support

US Sales Support

Sales Support Global

The typical TheraTogs client receives up to 10 hours
of wearable therapy every day!

Register Your TheraTogs Product

Product Registration

Purchaser / Caregiver Information

We guarantee the privacy of any data you provide us. Your information will not be shared, and you’ll receive a confirmation email when you submit this form. You can review our full Privacy Policy here.

Product Information

Quick Survey

Do you have any questions?

Therapy you can wear…

Join Our Mailing List

Facebook Feed

Quick Links

Contact Information

Customer Support

Clinical Support

US Sales Support

Sales Support Global

The typical TheraTogs client receives up to 10 hoursof wearable therapy every day!

The typical TheraTogs client receives up to 10 hours
of wearable therapy every day!