To minimize the waiting period as much as possible, please print out the forms and bring a completed copy with you to your appointment.
Please fill out all forms that are applicable to you or your child.
Forms can be faxed to (863) 682-1348 or mailed to 3020 Lakeland Highlands Road, Lakeland, FL 33803
Required For All Patients
Physician referrals to the Center are quick and easy.
To refer a patient for a speech or language consultation
Please call Beatrice Lopez at 863-686-3189, or email firstname.lastname@example.org.