Getting Started With Creating Communicators Rocky Mountain

To streamline your onboarding process, we utilize IntakeQ for all our necessary paperwork. 

1. AAC Consult Scheduling Survey

2. Patient Insurance Information and Release:

   1. Please provide us with your insurance details to facilitate a smooth billing process.

3. Speech Therapy Background Information:

   1. Share essential background information about your child to help us customize their care.

4. Food Allergies and Diet Restrictions

5. Release of Information (ROI):

   1. Authorize us to communicate with other professionals or family members as needed for the best care.

6. HIPAA Notice of Privacy Practices:

   1. Familiarize yourself with your rights and our practices regarding your protected health information.

7. Authorization for Use and/or Disclosure of Protected Health Information:

   1. This form ensures we handle your health information responsibly and with respect to your privacy.

Additional Disclosure:

Please note: Your privacy is our utmost priority. The information in these forms is protected under the Health Insurance Portability and Accountability Act (HIPAA) and will be used solely to initiate and provide specialized communication services..