Intake Information Forms

Below are the intake forms necessary to schedule an evaluation or treatment session. Our office manager, can tell you which forms you will need.

Food Required for an Orofacial Myofunctional Evaluation

(Food your child enjoys)

1. Pudding texture - like yogurt, apple sauce, or pudding

2. Soft-chew texture - like a banana, cheese, or soft cookie

3. Dry crunchy salty texture - like pretzels, crackers, or chips

4. Juicy texture - like apples, strawberries, or grapes

Insurance Information

Out of Network