Pediatric Forms (Ages 3-9)
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 – Ex: Prior evaluation reports, Reports from doctors or other therapists, Educational Reports, etc.
There are three ways to complete and submit these files:
1. ONLINE: Once all of the forms have been downloaded, please 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, please save your files on your device. To submit your completed forms: (A) Email the completed forms, along with any additional documents, to: info@horizonspeech.com (B) UPLOAD: You can upload your completed files directly into the form below
2. PRINT & SCAN: Print the forms, and fill out the information using blue or black ink. 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. To submit your completed forms: (A) Email the completed forms along with any additional documents to: info@horizonspeech.com. (B) UPLOAD: You can upload the documents directly into the form below. NOTE: 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. form below.
3. PRINT & MAIL: Print the forms, and fill out the information using blue or black in. Once you’re done, please place the completed forms, along with any additional documentation you may have, and mail to: Horizon Speech Therapy Services, LLC 780 Cedar Lane, Suite 3, Teaneck, NJ 07666. NOTE: No appointments will be scheduled until ALL of your completed paperwork has been received. Please call or text our office to confirm that we have received your completed forms.
