A streamlined referral process for physicians and healthcare providers. One universal form routes families to the right program-quickly and easily.
Thank you for partnering with Kids on the Move to support the children and families in our community. We know your time is valuable, so we've replaced our multiple program-specific forms with a single universal referral form that covers all of our services, including ABA Therapy, Diagnostic Evaluations, Early Intervention, and more.
Fill out and submit the universal referral form directly through our secure provider portal - no printing or faxing required
Prefer a paper form? Download our printable PDF referral form and fax or email it to our intake team at your convenience.
Send printed referrals to our intake fax line at 844-566-2689. You may also email completed forms to getstarted@kotm.org with the subject line: Referral: [Child’s Name].
At Kids on the Move, we provide comprehensive services to empower children and families with the support they need to thrive.
Autism Center
Family Support Services
Mat Datstrop, Chief Financial Officer at KOTM, truly embodies a blend of expertise and visionary leadership. Joining Kids on the Move in September 2019, Mat brought a rich history of accomplishments, having served as CFO for manufacturing and software companies. His successful track record includes starting and selling three businesses, showcasing his entrepreneurial spirit and strategic insight. As a licensed CPA and a Six Sigma Black Belt, Mat’s skill set is uniquely suited to driving innovation and accuracy within financial processes. His passion for integrating technology and developing robust accounting systems positions KOTM for long-term success. In his role, Mat is deeply dedicated to creating sustainable impacts that will echo throughout KOTM for decades. His presence in the organization is marked by a steadfast commitment to fostering an environment of lasting change, ensuring families benefit from his transformative work well into the future.
Ryan Erickson, the Chief Operating Officer of KOTM, brings extensive experience and a passionate commitment to nurturing innovation and growth. With over two decades spent as a thought leader and innovator across leadership roles in the medical, software start-ups, technical consulting, and information technology sectors, he has steered successful technology companies to new heights.
Ryan’s expertise is unparalleled. His dedication to mentoring entrepreneurs and CEOs in transforming ideas into reality speaks to his compassionate nature and deep-seated commitment to growth. Serving on several software and technical company boards, Ryan consistently helps these companies reach new heights.
At KOTM, Ryan is uniquely positioned to guide the organization into its next 40 years. His diverse skill set enables KOTM to not only meet current challenges with agility but also to strategically position itself for future growth under his committed leadership. Ryan continues to inspire hope and innovation, reinforcing KOTM’s status as a beacon of support and transformation for families everywhere.
Rutherford is the strategic visionary and Chief Executive Officer of Kids on the Move (KOTM). A multifaceted and sophisticated businesswoman, she has led the trailblazing multimillion-dollar non-profit in its commitment to providing essential and comprehensive support, education, and therapies for children with delays and disabilities. Rutherford has now spent 20 years in executive leadership roles within the telecommunications, genealogy, real estate, health care services, and education industries. Her notable contributions lie in her perseverance to find impossible and impactful solutions. Rutherford is skilled at reverse-engineering goals by mapping out exactly what is required for a successful outcome.
To help raise $150M to expand KOTM’s support services and establish a state-of-the-art center, Rutherford has partnered with Forbes Books to author and publish Chasing The Impossible, a captivating exposé delving into Kids on the Move’s transformative work. With it, she uncovers the compelling stories of resilience and hope from children, families, doctors, and community members who tenaciously pushed forward when faced with impossible odds or challenges.
Her profound understanding of what it takes to overcome the impossible stems from her own journey as a survivor of abuse and trauma, which has shaped her philanthropic missions, her intuitive nature, and her steadfast leadership. As a CEO, mom, speaker, and philanthropist, Rutherford believes discipline is one of the highest forms of self-love, consistently putting in the necessary work every single day to provide impactful solutions for others, promote a balanced and holistic lifestyle, and create opportunities for continuous growth and empowerment around the world.
