Forms
#1 - New Patient Forms
NOTE: Prior to completing New Patient Forms, please review the Billing & Policies section under the Patients tab. After review, please print, complete and bring all New Patient Forms with you to your first appointment. We cannot provide services unless completed and signed forms are received.
#2 - Speech Language/Feeding Case History
Required for speech, language, feeding and tongue thrust evaluation.
#3 - Feeding Questionnaire
Required for feeding/swallowing evaluation.
#4 - AAC Evaluation Vocabulary Questionnaire
Required for AAC Evaluation.
#5 - Occupational Therapy Case History
Required for fine motor, sensory integration and full occupational therapy evaluations.
#6 - Social Skills Checklist
Required for participation in social skills group sessions.
#7 - Literacy Case History
Required for literacy evaluations.
#8 - Record Release Authorization
Required to release any information to or from this facility.