Now providing Speech Therapy across Texas through telehealth services
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Please print the appropriate forms (below) and fax or email them to us, along with a photocopy of the front and back of your driver’s license and insurance card(s). Our administrative team will call to verify your insurance coverage. Once received, we will call you to schedule your evaluation. After the evaluation, our therapist will make recommendations regarding therapy and treatment programming.
Please print and complete the appropriate form(s), make front/back copies of your driver’s license and insurance card(s), and send to referrals@babeltherapy.com or fax to (936)703-5065.
Babel Pediatric Intake Packet (pdf)
DownloadAdult Congenital Intake Packet - Patient has a disorder affecting their communication since birth (pdf)
DownloadAdult Acquired Intake - Patient has accident or diagnosis affecting communication later in life (pdf)
DownloadCredit Card Authuthorization Form (pdf)
DownloadChange of Providers (pdf)
DownloadConsent to Exchange Information (pdf)
DownloadSpeech therapy prescription (pdf)
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