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Requesting Clinic Services

Referrals may be made by self, parent, physician, educator,psychologist or any other related professional or agency. We are a health care provider for many third-party insurance companies. For insurance coverage doctor's orders are frequently requested. We are not a Medicare provider. Contact the clinic to inquire about specific insurance and payment needs.

Please Note: The Hearing and Speech Clinic will accept completed paperwork via fax, mail, or hand carried to the clinic.

Hearing Services:

For hearing loss related services please use the age-appropriate case history form:

Adult Audiology

Child Audiology

Speech and Language Services: 

For Speech and language services please use the age-appropriate case history form:

Adult Speech-Language

Child Speech-Language

Privacy:

Summary of Patient Privacy (HIPAA)

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