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</div> </div> </div> </div> <nav id="sticky-nav" class="site-nav"> <div class="grid-container"> <div class="grid-x align-middle"> <div class="cell small-8 medium-3 large-2"> <a href="https://westsidechildrenstherapy.com" class="logo"> <img src="https://westsidechildrenstherapy.com/wp-content/uploads/2025/09/logo.png" alt="Westside Children’s Therapy"> </a> </div> <div class="cell small-4 medium-9 large-10 text-right"> <div class="sub-phone"> <span class="h4">Call Us</span> <span class="h3"> <a href="tel:(815) 469-1500">(815) 469-1500</a> </span> </div> </div> </div> </div> </nav> <!-- Rest of your site's content --> <main id="site-content" role="main"> <!-- Hero Section --> <section class="page-hero-section" style="background:var(--dkblue) url('https://westsidechildrenstherapy.com/wp-content/uploads/2025/10/SchaumburgWest11-scaled-1920x700.jpg'); background-size:cover; background-position:center top; background-repeat: no-repeat;"> <div class="overlay"></div> <div 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pb61"> <div class="grid-container"> <div class="grid-x grid-padding-x align-middle"> <div class="small-12 cell text-center"> <div class="w70"> <h2 data-aos="fade-up">Thank you in advance for getting in touch with Westside.</h2> <div data-aos="fade-up" data-aos-delay="200"> <p>We can’t wait to to speak with you.</p> <p>Please complete the form below and select the team you want your message sent to. We typically respond in 1-2 business days.</p> <p>If you are a medical provider looking to fax us documents, here is the #:<strong>(779) 216-3069</strong>. If you are a student looking for observations, please <a href="https://westsidechildrenstherapy.com/careers/students/">apply using this application</a>.</p> </div> </div> </div> </div> </div> </section> <section class="section-grey pb41"> <div class="grid-container"> <div class="grid-x grid-padding-x grid-padding-y align-middle"> <div class="small-12 cell"> <div class="w70"> <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' style='display:none'> <div class='gform_heading'> <p class='gform_description'></p> </div><form method='post' enctype='multipart/form-data' id='gform_4' action='/contact/' data-formid='4' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LdB9fArAAAAAMNJxov7owXj-OW4Fi3XsOXgL2Na' data-tabindex='0'><input id="input_1c9cb9763a57953039690a5d3630d98b" class="gfield_recaptcha_response" type="hidden" name="input_1c9cb9763a57953039690a5d3630d98b" value=""/></div> <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id="field_4_5" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_5'>Please indicate the intent of your inquiry.<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_4_5' class='large gfield_select' aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please choose inquiry intent</option><option value='Therapy Intake Coordinator' >I want to ask about therapy services.</option><option value='Insurance Specialist' >I want to ask about insurance coverage for therapy.</option><option value='Fieldwork/Students/Interns Coordinator' >I want to ask about fieldwork or observations.</option><option value='Human Resources Department' >I want to ask about jobs or other related HR topics.</option></select></div></div><div id="field_4_4" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_4'>Your Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_4_4' type='text' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_4_11" class="gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_11'>If therapy related, what is the FIRST NAME of the child you are inquiring about services for?</label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_4_11' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_4_12" class="gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_12'>If therapy related, what is the LAST NAME of the child you are inquiring about services for?</label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_4_12' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_4_8" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_8'>Which clinic does this question most closely relate to?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_4_8' class='large gfield_select' aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Choose clinic</option><option value='Carol Stream' >Carol Stream</option><option value='Dekalb' >Dekalb</option><option value='Downers Grove' >Downers Grove</option><option value='Elmhurst' >Elmhurst</option><option value='Frankfort' >Frankfort</option><option value='Geneva' >Geneva</option><option value='Glen Ellyn' >Glen Ellyn</option><option value='Headquarters' >Headquarters</option><option value='Homer Glen' >Homer Glen</option><option value='Joliet' >Joliet</option><option value='Lockport' >Lockport</option><option value='Lombard' >Lombard</option><option value='Machesney Park' >Machesney Park</option><option value='Naperville' >Naperville</option><option value='New Lenox' >New Lenox</option><option value='Oak Lawn' >Oak Lawn</option><option value='Orland Park North' >Orland Park North</option><option value='Orland Park South' >Orland Park South</option><option value='Oswego' >Oswego</option><option value='Park Ridge' >Park Ridge</option><option value='Plainfield Downtown' >Plainfield Downtown</option><option value='Plainfield North' >Plainfield North</option><option value='Rockford' >Rockford</option><option value='Schaumburg East' >Schaumburg East</option><option value='Schaumburg West' >Schaumburg West</option><option value='Shorewood' >Shorewood</option><option value='Tinley Park' >Tinley Park</option><option value='Wheaton North' >Wheaton North</option><option value='Wheaton South' >Wheaton South</option><option value='Willowbrook' >Willowbrook</option></select></div></div><div id="field_4_9" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_9'>Phone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_4_9' type='tel' value='' class='large' aria-required="true" aria-invalid="false" /></div></div><div id="field_4_2" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_2'>Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_2' id='input_4_2' type='email' value='' class='large' aria-required="true" aria-invalid="false" /> </div></div><div id="field_4_3" class="gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" ><label class='gfield_label gform-field-label' for='input_4_3'>Your inquiry<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_textarea'><textarea name='input_3' id='input_4_3' class='textarea medium' 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