New Patient Information
 
Save yourself some time and fill out the forms below to bring in with you on your evaluation.
Don't forget to bring in you or your child's insurance ID card and your driver's license.
  

Insurance Information:

In-Network Providers for:

  • Sunshine/Children's Medical Services (CMS) Title 19
  • Sunshine/Children's Medical Services (CMS) Title 21
  • Straight Medicaid
  • United Healthcare/Medicaid
  • United Healthcare/Private
  • Florida Blue
  • Family Empowerment Scholarship (PLSA/Gardiner) Providers
  • Tricare/Prime
  • Tricare/Standard

 

*All above insurance is accepted upon verification of eligibility and benefits.

 

 United HealthCare Grant Opportunity

The UnitedHealthcare Children's Foundation® (UHCCF) provides medical grants to qualified families enrolled in employer-sponsored health coverage, or who have purchased an individual policy, to help pay for child health care services such as speech, physical or occupational therapy, prescriptions, and medical equipment. 

Parents and legal guardians may apply for grants of up to $5,000 for child medical services and equipment by completing the online application. 
 
 Small Steps in Speech Grant Opportunity
Small Steps in Speech is a charitable non-profit organization which provides grants on behalf of children with speech and language disorders for therapies, treatments, communicative devices, and other services aimed at improving their communication skills. A grant from Small Steps in Speech provides financial support for families seeking speech and language services for their children, either not covered or not fully covered by their health care plan. Small Steps in Speech also helps other qualified non-profit organizations by awarding grants to help fund programs and services aimed at improving the communication skills of children. 
 Parents can apply on the Small Steps in Speech website here
 
 
 
NEW PATIENT PAPERWORK 
 

Speech Therapy Intake Paperwork

Feeding Therapy Paperwork Updated 2023





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