Do you have health insurance?
What is the name of your insurance provider?
Please include your Member ID:
Uploading your card is optional, but doing so helps us correctly confirm your insurance information before we speak with you.
Please include your Zip Code:
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Great, now let’s find out more about who this service is for.
State of Residence
Due to regulatory limitations, we are unable to provide services to clients currently located outside the United States.
What issues or concerns are impacting your speech or ability to communicate? (Hold the shift key down when clicking to select all that apply)
What are your most important speech therapy goals?
On average, speech therapy is about $130 per week. Are you able to invest that amount? (We do accept HSA and FSA.)
Thanks for sharing all your info! Let’s schedule your introductory phone call.
Choose a day and time that works best for you to chat with a team member:
We have received your complimentary consultation form, scheduled on ***. A Great Speech team member will review the completed form on a phone conference with you prior to your scheduled online consultation.
Your online complimentary consultation will be administered via secure video conference and can be accessed from any laptop or computer with microphone and webcam capabilities.
A plan of care and payment options will be discussed during your call.
The Great Speech Team
Tailored, effective, convenient speech therapy that fits around your life.
How did you hear about us?
For assistance completing this form, please call us at +1-954-820-7400 between 8am and 6pm EST.
Please select a time slot for your consultation.