Getting Started

Here’s what you need to get started with us.
We’ve tried to make this as simple and paperless as possible.
Hopefully, we succeeded ! ;)

Intake Form
Please fill out this web-based form (you don’t need to print it out).
This is your first contact with us (of course, you can call us as well!).

Consent for Services Form
Please print, sign, and bring the Consent for Services Form to our first meeting.

Credit Card Authorization Form
Please print this Credit Card Authorization form, fill out the hard copy, and give the form to your therapist at the first scheduled meeting. Playworks Speech Therapy accepts all major credit cards. We will charge your card automatically, unless you request to pay by cash or check and payment is made at the time of service.

If a credit card transaction is unsuccessful and payment has not been received, we cannot commit to any additional service. If you are uncomfortable providing a credit card number, one month of sessions must be pre-paid before therapy can begin. The amount to be paid upon the first meeting is $500 ($125.00 a week for 4 weeks).

Case History Form Please fill out this web-based form (you don’t need to print it out).
This is the medical case history form which will give us more information about how best to treat your child.