Infant-Toddler Forms

Please click on the forms below to download them.  Once you have downloaded them, please follow the directions below about how to complete and return the forms to us.   Additionally, please send us all previous documents you have – Such as:  Any prior evaluation reports, Reports from doctors or other therapists, Educational Reports, etc.

 There are two ways to complete and submit these forms:

1. Open each form with a PDF-filler app/program (ex: Adobe;  or free online programs such as: PDFfiller.com;  PDFSimpli.com, etc.).  Please use a PDF-filler ONLY (you are only filling it out, not “editing” the PDF).  It is recommended that you do this on a computer rather than on a mobile device.  Once you have filled out all of the information on the form, make sure to save the file on your computer.  Repeat this process with ALL of the forms.  Lastly, send all of the completed (saved) files, along with any additional documents, to:  info@horizonspeech.com  Or,  upload  the files directly into the form below

2. Print the forms, and fill out the information by hand.  The completed forms must be scanned and emailed to us (photos of forms will not be accepted).  Please also scan and email any additional documents.  Our email is:  info@horizonspeech.comAlternatively, you can scan and save the files to your computer and upload the files directly into the form below.       If you do not have access to a scanner, you can go to any office supply type store (ex: Staples, Office Max/Depot, FedEx Office, UPS stores, etc.), as most of them have scanning services.  Please call or email us to confirm that we have received your completed forms.

NOTE:   All of your completed forms MUST be received in order for us to schedule your appointment. 

  

              

Click or drag files to this area to upload. You can upload up to 10 files.