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Page 1Dual SLP/AUD ApplicationUpdated 1/3/20MONTANA BOARD OF SPEECHLANGUAGE PATHOLOGISTS AND AUDIOLOGISTS PO BOX 200513 301 S PARK, 4TH FLOOR Helena, MT 596200513 Licensing Phone: 4064446880 Email:
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Page 1 speech-language pathologist refers to the initial page of a specific reporting form used by speech-language pathologists to document services and patient interactions.
Speech-language pathologists who provide services that require documentation for reimbursement or regulatory compliance are required to file page 1.
To fill out page 1, a speech-language pathologist should provide their personal details, patient information, service dates, and descriptions of the services rendered, ensuring all fields are accurately completed.
The purpose of page 1 is to serve as an official record of services provided by speech-language pathologists, facilitating communication with insurance providers and ensuring compliance with regulations.
Information that must be reported includes the practitioner’s name, patient’s details, service dates, the type of services provided, and any relevant codes or identifiers.
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