Client Forms

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The following forms can be:

Submitted online or
Printed from a PDF file (Adobe Reader required). Please fax the PDF form to Nancy Foreman at 713-218-7593 or email to info@houstonspeech.com.
Completing online forms on a computerPlease click on the link of your choice.

Client Information

General Case History: Child

General Case History: Adults

Consent to Treat/Release Information

Informed Consent for Teletherapy

Teletherapy Credit Card Authorization Form

 

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