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FORMS

If you've requested an evaluation and have been directed to complete the online intake forms, you're in the right place. 

We've made our intake process entirely digital now to save time, increase efficiency and to protect confidentiality with less physical paperwork.

Simply click the forms required, submit, and we will be in contact with you. 

Please Fax any additional supporting information to 843-582-0259  or secure email it to hello@communicationcottagetherapy.com

SUBMIT A REFERRAL - START HERE

Please visit the request an evaluation page on our website.

Complete and we will be in contact when we can schedule services.

You may follow up at any time on referrals submitted.

PRIVATE PAY POLICY + CONSENT

If you are requiring services but do not

have an insurance that we are able to accept -

Please complete the private pay consent form.

PEDIATRIC CASE HISTORY

For all children coming into our care we require a case history form

to allow us to get to know your family member and to

take a holistic and strengths based approach.

If you have concerns regarding your child's feeding and/or swallowing skills please complete this form to provide further information about your child's experience with eating.  Most often your child's treating therapist will direct you to this form if it is needed to be completed; however, if you want to be proactive and complete this if you have concern we greatly appreciate it and will share the form with your child's therapist. 

FEEDING FORM

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