Appointment/Evaluation Request
*Fill out the following forms ONLY if you have an appointment scheduled
Authorization to Disclose Medical Records (Use to add new facility, practice, or person)
We are an in-network provider for:
Anthem Blue Cross Blue Shield
Tricare
We do not accept any other insurances or health plans.
Private (Cash) Pay: Give us a call or email for current rates: 719-999-8417.
We have created this worksheet to help you determine if your health plan will cover therapy. We strongly encourage you to use this when calling your insurance company, it will help avoid possible problems
Worksheet: Does my Insurance Cover Speech Therapy