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SPEECH THERAPY PATIENT REFERRAL & PRESCRIPTION FORM 747 52nd St., Oakland, CA 94609 5104283000 www.childrenshospitaloakland.orgDATE PATIENT INFORMATIONREFERRING MD CONTACT INFORMATIONPatients First
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Step 1: Start by gathering all the necessary information about the patient, such as their personal details, medical history, and any previous speech therapy treatments they have received.
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Step 2: Assess the patient's current speech-related difficulties or goals. This may involve conducting various tests and evaluations to determine their specific needs.
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Step 3: Create a treatment plan tailored to the individual patient. This plan should outline the specific speech therapy techniques and exercises to be used, as well as the frequency and duration of therapy sessions.
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Step 4: Begin the speech therapy sessions, following the treatment plan. These sessions may involve a combination of exercises, drills, and activities designed to improve the patient's speech and language skills.
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Step 5: Monitor the patient's progress throughout the therapy process. Regularly evaluate their speech abilities and make any necessary adjustments to the treatment plan based on their development.
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Step 6: Provide the patient with feedback and guidance during the therapy sessions. Help them practice and refine their speech skills, offering support and motivation along the way.
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Step 7: Collaborate with other healthcare professionals or therapists involved in the patient's care, if necessary. Communication and coordination can help ensure a comprehensive and holistic approach to their speech therapy.
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Step 8: Continuously assess and reassess the patient's progress and adjust the treatment plan accordingly. Regularly review goals, achievements, and challenges to optimize the effectiveness of the speech therapy.

Who needs speech formrapy patient?

01
Individuals who have speech-related difficulties or disorders may benefit from speech therapy. This can include people with conditions such as stuttering, articulation disorders, language delays or disorders, voice disorders, aphasia, or dysarthria.
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Children with speech and language developmental delays or disorders may also require speech therapy to improve their communication skills and enhance their overall development.
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Speech therapy patients may include individuals of all ages, from infants to adults, depending on their specific needs and goals.
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Speech therapy is often recommended by healthcare professionals, such as pediatricians, otolaryngologists, neurologists, or psychologists, who have identified speech-related difficulties in their patients.
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It's important to note that the need for speech therapy should be assessed and diagnosed by qualified professionals in the field, based on comprehensive evaluations and individualized treatment plans.
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Speech therapy is a treatment for speech and language disorders.
Speech therapists or healthcare providers who perform speech therapy on a patient.
The speech therapy patient form should be filled out with the patient's information, treatment plan, progress notes, and any other relevant details.
The purpose of the speech therapy patient form is to document the patient's progress, track treatment plans, and ensure proper communication between healthcare providers.
Information such as patient demographics, medical history, treatment goals, progress notes, and treatment plans.
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