Forms

Get started by completing the necessary forms below

Below you will find forms to provide your child's medical information, billing information and our billing policies and procedures. Please complete these forms and return them either by email, fax or mail. If you can provide a copy of your insurance or Medicaid card, that would be helpful.

Please note that your therapist will do their best to accommodate your schedule for therapy and we ask that if you need to cancel your child's therapy session, please contact your therapist as soon as possible so that a make-up session can be scheduled. Children's Therapy Group, Inc. allows up to 3 unexcused cancellations before services are suspended.

If you have any questions regarding billing or your insurance please feel free to contact myself or Tracey, our billing assistant, at the number below.

Sincerely,

Brook Todd, M.Ed., CCC-SLP
Owner/Speech-Language Pathologist

New Patient Info Authorization

All new clients need to complete this paperwork. This includes client details, insurance information, medicaid details, etc.

Billing Policies & Procedures

Please review and authorize Children's Therapy Group to provide therapy services and to receive payment for those therapy services.

Still have questions? We're here to help.