Aquatic Therapy at JS Therapies
We are excited to partner with the. St. Croix Swimming Association to provide aquatic therapy on St. Croix! 
Our lead Physical Therapist, Keishla Gonzalez Acosta, is providing aquatic therapy services at the Good Hope Country Day School Pool on Wednesday afternoons. 

WAIT-LIST ONLY AT THIS TIME. Please sign up to indicate interest and we can contact you with openings.
Availability is limited and spots will be filled on a first-come first-served basis. Our Patient Care Coordinator can help you understand if there are any insurance limitations to participation.

Please feel free to contact us with any questions! 
aquatic@jtherapies.com
(340) 473-5924
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Email *
Child's First & Last Name *
Child's Date of Birth *
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Guardian's First & Last Name *
Phone #
Do you currently receive therapy services with JS Therapies? 

*If you have not been receiving PT with us, your child will need a land-based PT Evaluation prior to participating in the aquatic therapy program. 
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Child's Pediatrician *
What do you hope your child will achieve as a result of participation in aquatic therapy?
Is there anything you would like to share with us about your child as it relates to participating in aquatic therapy?
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