Patient Registration Form

If you are scheduled for speech and language therapy with us, please fill out the consent form and appropriate patient history form below at least 24 hours before your first appointment

Patient Consent & Cancellation Policy Form

Child Patient History Form

Adult Patient History Form

Notice of Privacy Practices

If you are a self-pay patient or you have an insurance plan we do not accept that does not cover out-of-network providers, please fill out the terms of payment form below. If you have questions regarding your insurance visit our Payment & Insurance section or call us at (202) 579-4448

Terms of Payment

Note: All our forms are Google Forms and are HIPPA compliant. Click here to learn more about how we keep your information safe.