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Registration Forms

If you are unable to complete the registration forms through the patient portal, please complete these forms and email to 48 hours prior to initial evaluations. 

Intake paperwork needed for first visit

Intake form for speech therapy

Activities Balance Confidence Scale
*If you are coming for physical or occupational therapy.

Dizziness Handicap Inventory
*If you are coming for dizziness therapy.

Voice Handicap Index
*If you are coming for speech therapy.

Medical Information Release - If your medical notes need to be sent to a different medical provider

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