Speech Therapy | Medicare Medicaid |Because You Can | St. Petersburg

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Patient Forms

Please complete and return to our office via the following:

EMAIL

admin@becauseyoucanllc.com

FAX

(727) 914-6904

MAIL

5225 Central Ave

St. Petersburg FL 33710

Patient Intake: Pediatrics

Patient Intake: Adult

HIPAA Compliance

General Consent to Treat

Medical Release

Financial Consent

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