Case History Form

PHI Disclosure Consent to Treat

HIPAA Notice Acknowledgement and Consent

Insurance and Fees Agreement

Requirements for Non-Network Claims

Opt Out Insurance Filing

Parent Responsibility & Authorization Form

Have questions about your child’s speech and language skills? Please contact us!

We are happy to answer your questions and guide you in the right next step for you. We can schedule a speech and language assessment to determine if your child would benefit from speech and language therapy. If you have a current speech and language assessment, we may be able to go ahead and schedule weekly treatment sessions.