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Getting Started

Thank you for accessing our website to print off therapy intake forms for your child. You may either fax the forms to us at 351-1644 prior to your appointment or bring them in with you when you arrive to your appointment. All new patients need to complete the first five forms. Please complete the additonal forms needed for each specific therapy your child will be receiving. Please call with any questions!

1. Pediatric Intake Personal Insurance
2. Release of Information
3. Financial Statement and Policy
4. Medical History
5. Know Your Insurance Policy
6. HIPAA Policy
7. Communication Therapy Intake
8. Physical and Occupational Intake
9. Pediatric Swallow Intake
10. Pediatric Swallow Diet Diary