New Patient Forms
New Patient Forms for Adults
Please obtain a prescription for “speech to evaluate and treat” prior to your appointment or your appointment will be rescheduled.
New Patient Intake Forms
Insurance Verification, Financial Policy, Cancellation Policy, Consent to Treat Forms
This form must be filled out and returned before scheduling your first visit.
Download the PDF
Adult Medical Questionnaire
This form must be filled out prior to first session after appointment is scheduled.
Download the PDF
New Patient Forms for Pediatrics
Please obtain a prescription for “speech to evaluate and treat” prior to your appointment or your appointment will be rescheduled.
New Patient Intake Forms
Insurance Verification, Financial Policy, Cancellation Policy, Consent to Treat Forms
This form must be filled out and returned before scheduling your first visit.
Download the PDF
Pediatric Medical Questionnaire
This form must be filled out prior to first session after appointment is scheduled.
Download the PDF
New Patient Forms for Auto Accidents
Please obtain a prescription for “speech to evaluate and treat” prior to your appointment or your appointment will be rescheduled.
New Patient Intake Forms
Insurance Verification, Financial Policy, Cancellation Policy, Consent to Treat Forms
This form must be filled out and returned before scheduling your first visit.
Download the PDF
Pediatric Medical Questionnaire
This form must be filled out prior to first session after appointment is scheduled.
Download the PDF
Adult Medical Questionnaire
This form must be filled out prior to first session after appointment is scheduled.
Download the PDF
Assignment of Rights Form
This form must be filled out monthly for auto accident patients.
Download the PDF
New Patient Forms for Private Pay Massage Therapy
Massage Therapy Uninsured Medical Case History
This form must be filled out prior to first session after appointment is scheduled.