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.