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FORMULARIOS DE ADMISIÓN CLÍNICAAshley Johnson2025-05-07T14:24:08+00:00

Below are the forms that I use within my practice.
Please fill out the five forms before your first visit.

Click to review my Notice of Privacy (HIPAA) form.

FORMULARIOS DE ADMISIÓN CLÍNICA

1. Política de facturación
2. Consentimiento para Divulgar Información Médica Confidencial
3. Cuestionario Sobre el Historial Clínico
4. Formulario de Admisión
5. Consentimiento Informado para Terapia del Lenguaje
Speak Up Speech Therapy LLC
Clackamas Professional Plaza
9123 SE St. Helens st. STE 255B
Clackamas, OR 97015
503-974-6774
503-662-1015 (FAX)
ashley@speakupspeechor.com
Privacy Policy
Hours
Mon: 9:00 am - 6:00 pm
Tue: 9:00 am - 6:00 pm
Wed: 9:00 am - 6:00 pm
Thu: 9:00 am - 6:00 pm
Fri: 9:00 am - 6:00 pm
Sat: Closed
Sun: Closed
CONTACT US!
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