New Patient Forms
Building Blocks Therapy Speech therapy geneva il
Thank you for choosing Building Blocks Therapy. We look forward to meeting you and your family!
Prior to your evaluation:
You may want us to call and check into your insurance benefit details. In order to do this, we will need you to contact us so we can do an intake form. We will talk to your insurance company and let you know what we find out.
*It is your responsibility to contact the insurance company and verify your own benefits regarding coverage of the services as well. We are not responsible for the determination of payment or denial by your insurance carrier. We recommend you contact your carrier directly with questions regarding their determination.
Please bring with you to your evaluation:
CLIENT HISTORY FORM. Please download, print and complete the Client History form and have it available for the evaluation. This saves time and allows us to focus on what is most important.....your child!
If you have the time and ability to send it in prior to your child's first session it will save time during the initial session. You can do this by faxing forms to 331-248-0252 or emailing as an attachment to firstname.lastname@example.org.
We would also appreciate a copy of any prior evaluation reports that can help us better diagnosis your child. These reports can be sent in to the email or fax above.