If after your initial call, a speech language evaluation is recommended, a convenient day and time will be selected and you will be asked to fill out our forms packet.

Insurance may cover a portion of your child’s evaluation. If you would like to use your insurance for services, we will provide a link to our insurance portal so that we can determine if coverage is available. Click here for a current list of in network insurance carriers.

Our Forms

Below you will find the forms we require to be completed prior to your child’s evaluation.
Please request a prescription from your child’s pediatrician for "Speech Evaluation and or Treatment”.

Prescriptions can be faxed to (847) 329-8252

Thank you

Photo/video release



Consent for release


History form

Financial forms




Medical liability waiver



Teletherapy consent form