GOEPFERT SPEECH ASSOCIATES, LLC
DOCUMENTS:
Below is a list of documents for you to download and print to complete and return to the office prior to your appointment for review.
1. About Goepfert Speech Associates, LLC
2. Child History Form
3. Release Form
4. Confidentiality Form
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5. Treatment Contract
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6. Health Insurance Claim Form (HICF)
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7. Health Insurance Protection and Portability Act (HIPPA) Form
8. Childhood Onset Speech Fluency (Stuttering) Questionnaire for Parents to complete
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9. Adult Speech Fluency (Stuttering) Questionnaire
10. Pragmatic Language Chart Checklist 3 pages
11. Adult History Form 4 pages
12. Transgender Clients TVQ- 1 page
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