Therapy Visit Forms
Step-by-step directions to prepare for your appointment:
As there are thousands of plans available to individuals and employers, there is no way for us know all of the specific limitations of your plan. The tools below will help you understand your plan better and provide the best chance of maximum coverage for your treatment.
STEP 1: Print out your Speech History and Intake Forms
Print the forms that describe you, fill them out and bring them to your appointment with you.
STEP 2: Select your insurance company and follow the instructions provided
STEP 3: Help us get your previous medical records
Please call the doctor who referred you and ask them to fax your evaluations and office notes to us at (781) 329 - 2207 PRIOR TO your appointment date. This will allow your clinician to properly prepare for your evaluation.
STEP 4: Get directions to your therapy location
As there are thousands of plans available to individuals and employers, there is no way for us know all of the specific limitations of your plan. The tools below will help you understand your plan better and provide the best chance of maximum coverage for your treatment.
STEP 1: Print out your Speech History and Intake Forms
Print the forms that describe you, fill them out and bring them to your appointment with you.
- Forms for All Patients with a Voice Disorder
- Forms for Children with other Speech Disorders
- Forms for Adults with other Speech Disorders (available soon)
- View or print our PRIVACY POLICY
STEP 2: Select your insurance company and follow the instructions provided
- Do you have a GIC plan?
- Blue Cross Blue Shield of Massachusettts
- Blue Cross Blue Shield of Rhode Island
- Blue Cross Blue Shield Other Out of State Plans
- Harvard Pilgrim Healthcare (or HPHC/United joint plan)
- Tufts Health Plan (or Tufts/Cigna joint plan)
- Medicare
STEP 3: Help us get your previous medical records
Please call the doctor who referred you and ask them to fax your evaluations and office notes to us at (781) 329 - 2207 PRIOR TO your appointment date. This will allow your clinician to properly prepare for your evaluation.
STEP 4: Get directions to your therapy location
- Dedham: 597 High Street, Dedham, MA 02026
At the crossroads of Washington Street and High Street in Dedham Center, across the street from the police station.
We are at street level; on street parking; please come in and have a seat in the waiting area; your clinician will come and greet you when they are ready.
- Brockton: 35 Pearl Street, Brockton, MA 02301
In the same office building as ENT Specialists; come in the front door and into the glass door on the first floor.
- Chelmsford: 3 Meetinghouse Road, Chelmsford, MA 01824
In the same office building as Mass ENT Associates; come to the second floor; enter Suite 31 across from the elevators; the door states that you are entering Mass ENT Associates.