Initiate Services / Forms

Please take a moment to complete our questionnaire to help us determine if your child will benefit from speech and language therapy services.

Please Complete The Following Steps To Successfully Initiate Services:

1.  Contact your insurance company to verify if there would be coverage for the services your child needs. Questions to ask include:

  • If there is coverage, are there any exclusions?​​

  • Do I have a co-payment or is there a percentage of the bill I will be responsible for?

  • Does my plan require a deductible be paid for the calendar year before the coverage begins?

  • Does my insurance plan cover only a limited number of sessions for each calendar year?

  • Is there a requirement that I get a prior authorization and/or a referral/order from my physician before I see a clinician?


2.  Obtain order/referral from your child's physician if you haven't already.

  • The following form is provided for your convenience if you do not yet have a referral:

3.  The following forms must be completed and turned in prior to the first scheduled appointment:

If you have any questions please give us a call at (360) 630-8734 or send us an email.

© 2019 by The Speech Corner LLC. Proudly created with

Claire C. Davis, MS, CCC-SLP, is a licensed Speech-Language Pathologist. She holds a Master’s degree in Communicative Disorders and a Certificate of Clinical Competence from the American Speech-Language-Hearing Association (ASHA).

About The Speech Corner, LLC


Contact Information

Phone: 360.630.8734

Fax: 703.780.0518


Areas We Serve: Alexandria, Fort Hunt, Mount Vernon, Fort Belvoir, Lorton, Kingstowne, Franconia, and Newington.  If your area is not listed, please call to see if we are available!