How to Get Started
In order to provide the best service to your child as efficiently as possible, please follow the steps below:
- Call our Office, 770-410-7719, to discuss your child's needs and schedule an appointment.
- Complete our Speech/Language/Hearing Case History form AND Read or Payment & Policy Service Agreement (see pdf file below ), Print, then either fax to 770-410-9510, email to info@pedspchthpy.com, or bring it to your first session.
- Have your Primary Care Physician fax your child's Rx with Diagnosis to us at 770-410-9510.
- Please Note our Cancellation Policy to avoid any unnecessary charges.
| agreement_of_svc_release_payment_telemedicine_consent___case_history.pdf |
Cancellation Policy:
Our policy is to charge $50 for missed appointments not canceled before 12 hours of the scheduled appointment. These charges will be your responsibility and billed directly to you.
PLEASE NOTE: We understand emergencies arise and will work with you under these circumstances. If your child becomes sick the morning of your Therapy appointment we ask that you contact your Therapist immediately so they are aware.
More than two appointments not canceled within 12 hours due to sickness or other circumstance will result in a $50 charge.
We reserve the right to charge $50 as and for an appointment not canceled within 12 hours. In addition, we reserve the right to give your appointment time to another patient if the appointment is canceled two times within a given month (or for any other reason at our discretion).
NO SHOW (Not attending an appointment without notice and/or proper cancellation).
Not Showing for a scheduled appointment will not be tolerated and will result in the removal from the Therapy Schedule (at our discretion).
Patients/families insured thru a PeachCare for Kids or Medicaid Plan: If we do not receive follow-up communication of your future appointment intentions via email, voice mail or text to your Therapist, a Discharge Report will be sent to your child’s pediatrician and your child’s insurance provider.
If your child receives both Speech and Occupational Therapy services at our clinic:
Speech and Occupational Therapy is independent of each other. If your child is sick and you must cancel Speech Therapy with your Speech Therapist, you must also cancel Occupational Therapy with your Occupational Therapist.
If one of the Therapy times is re-arranged or re-scheduled, our office anticipates you will keep the regularly scheduled appointment with the other Therapy. Appointments that are not maintained on a consistent basis, may result in the removal from our Therapy Schedule.
Please help us to serve you better by keeping your scheduled appointments.
Our policy is to charge $50 for missed appointments not canceled before 12 hours of the scheduled appointment. These charges will be your responsibility and billed directly to you.
PLEASE NOTE: We understand emergencies arise and will work with you under these circumstances. If your child becomes sick the morning of your Therapy appointment we ask that you contact your Therapist immediately so they are aware.
More than two appointments not canceled within 12 hours due to sickness or other circumstance will result in a $50 charge.
We reserve the right to charge $50 as and for an appointment not canceled within 12 hours. In addition, we reserve the right to give your appointment time to another patient if the appointment is canceled two times within a given month (or for any other reason at our discretion).
NO SHOW (Not attending an appointment without notice and/or proper cancellation).
Not Showing for a scheduled appointment will not be tolerated and will result in the removal from the Therapy Schedule (at our discretion).
Patients/families insured thru a PeachCare for Kids or Medicaid Plan: If we do not receive follow-up communication of your future appointment intentions via email, voice mail or text to your Therapist, a Discharge Report will be sent to your child’s pediatrician and your child’s insurance provider.
If your child receives both Speech and Occupational Therapy services at our clinic:
Speech and Occupational Therapy is independent of each other. If your child is sick and you must cancel Speech Therapy with your Speech Therapist, you must also cancel Occupational Therapy with your Occupational Therapist.
If one of the Therapy times is re-arranged or re-scheduled, our office anticipates you will keep the regularly scheduled appointment with the other Therapy. Appointments that are not maintained on a consistent basis, may result in the removal from our Therapy Schedule.
Please help us to serve you better by keeping your scheduled appointments.