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Please download and print the following forms prior to your appointment:
Patient Registration Forms
Policy Statement and Good Faith Estimate
HIPAA Notice of Privacy Practices
Authorizations and Acknowledgments Form
Payment is due at the time of service. We accept payment in the form of credit card, check or cash. At this time, Clearly Speaking Therapy does not participate with any insurance companies and therefore, we are out of network. We do provide monthly statements that you can submit to your insurance company for reimbursement should you have out of network speech therapy benefits. Please contact your insurance provider for further details.
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