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SpeechLanguage Therapy PARKINSON DISEASE REFERRALS Patient Intake QuestionnaireName: Today's Date: Referring Physician: Neurologist: Date of PD diagnosis:1. 2. 3. 4. 5. Date of Birth: Age: Primary
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Speech-language therapy is a treatment for individuals who have difficulties with communication or swallowing.
Speech-language therapy can be recommended by a speech therapist, doctor, or other healthcare professional.
To fill out speech-language therapy, the individual or their guardian can contact a speech therapist or healthcare provider for an evaluation and treatment plan.
The purpose of speech-language therapy is to improve an individual's ability to communicate effectively and to swallow safely.
Information such as the individual's medical history, speech and language skills, and treatment goals must be reported on speech-language therapy forms.
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