{"product_id":"private-practice-intake-and-policies-template","title":"Private Practice Intake and Policies Template","description":"\u003cp data-start=\"274\" data-end=\"520\"\u003eStarting or growing a private practice means building systems that support both \u003cstrong data-start=\"354\" data-end=\"417\"\u003eexcellent clinical care and clear expectations for families\u003c\/strong\u003e. One of the most important systems in any practice is a well-designed \u003cstrong data-start=\"488\" data-end=\"519\"\u003eintake and policy framework\u003c\/strong\u003e.\u003c\/p\u003e\n\u003cp data-start=\"522\" data-end=\"787\"\u003eThe \u003cstrong data-start=\"526\" data-end=\"602\"\u003eNeuroaffirming Pediatric Speech Therapy Intake \u0026amp; Practice Policy Toolkit\u003c\/strong\u003e is a comprehensive, customizable template designed to help speech-language pathologists streamline their client onboarding process while maintaining neurodiversity-affirming practices.\u003c\/p\u003e\n\u003cp data-start=\"789\" data-end=\"982\"\u003eThis toolkit combines \u003cstrong data-start=\"811\" data-end=\"898\"\u003eclinical intake forms, caregiver questionnaires, and professional practice policies\u003c\/strong\u003e into one cohesive system that can be easily edited and adapted for your own clinic.\u003c\/p\u003e\n\u003cp data-start=\"984\" data-end=\"1187\"\u003eInstead of spending hours writing intake forms and policies from scratch, you’ll have a \u003cstrong data-start=\"1072\" data-end=\"1098\"\u003eready-to-use structure\u003c\/strong\u003e that supports clear communication, consistent expectations, and organized documentation.\u003c\/p\u003e\n\u003ch2 data-section-id=\"xydb7h\" data-start=\"1194\" data-end=\"1212\"\u003eWhat’s Included\u003c\/h2\u003e\n\u003cp data-start=\"1214\" data-end=\"1323\"\u003eThis toolkit provides a \u003cstrong data-start=\"1238\" data-end=\"1322\"\u003ecomplete intake and policy system for pediatric speech therapy private practices\u003c\/strong\u003e.\u003c\/p\u003e\n\u003cp data-start=\"1325\" data-end=\"1359\"\u003eSections included in the template:\u003c\/p\u003e\n\u003cp data-start=\"1361\" data-end=\"1385\"\u003e\u003cstrong data-start=\"1361\" data-end=\"1385\"\u003ePractice Information\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"1386\" data-end=\"1438\"\u003e\n\u003cli data-section-id=\"1z13pn5\" data-start=\"1386\" data-end=\"1412\"\u003e\n\u003cp data-start=\"1388\" data-end=\"1412\"\u003ePractice contact details\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1vhv7rp\" data-start=\"1413\" data-end=\"1438\"\u003e\n\u003cp data-start=\"1415\" data-end=\"1438\"\u003eClinic information page\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"1440\" data-end=\"1467\"\u003e\u003cstrong data-start=\"1440\" data-end=\"1467\"\u003ePediatric Client Intake\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"1468\" data-end=\"1553\"\u003e\n\u003cli data-section-id=\"1m590jy\" data-start=\"1468\" data-end=\"1487\"\u003e\n\u003cp data-start=\"1470\" data-end=\"1487\"\u003eChild information\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"15frq0k\" data-start=\"1488\" data-end=\"1525\"\u003e\n\u003cp data-start=\"1490\" data-end=\"1525\"\u003eParent\/guardian contact information\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"19foloj\" data-start=\"1526\" data-end=\"1553\"\u003e\n\u003cp data-start=\"1528\" data-end=\"1553\"\u003eEmergency contact details\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"1555\" data-end=\"1580\"\u003e\u003cstrong data-start=\"1555\" data-end=\"1580\"\u003eCommunication Profile\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"1581\" data-end=\"1680\"\u003e\n\u003cli data-section-id=\"4ak1jp\" data-start=\"1581\" data-end=\"1609\"\u003e\n\u003cp data-start=\"1583\" data-end=\"1609\"\u003eHow the child communicates\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"ch1p65\" data-start=\"1610\" data-end=\"1641\"\u003e\n\u003cp data-start=\"1612\" data-end=\"1641\"\u003eCurrent communication methods\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"arjmiz\" data-start=\"1642\" data-end=\"1680\"\u003e\n\u003cp data-start=\"1644\" data-end=\"1680\"\u003eSuccessful strategies already in use\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"1682\" data-end=\"1714\"\u003e\u003cstrong data-start=\"1682\" data-end=\"1714\"\u003eCommunication Accommodations\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"1715\" data-end=\"1828\"\u003e\n\u003cli data-section-id=\"1ka40ei\" data-start=\"1715\" data-end=\"1769\"\u003e\n\u003cp data-start=\"1717\" data-end=\"1769\"\u003eSupports that help the child communicate effectively\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"8n3mfn\" data-start=\"1770\" data-end=\"1802\"\u003e\n\u003cp data-start=\"1772\" data-end=\"1802\"\u003eProcessing time considerations\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"pby7bc\" data-start=\"1803\" data-end=\"1828\"\u003e\n\u003cp data-start=\"1805\" data-end=\"1828\"\u003eAAC and visual supports\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"1830\" data-end=\"1849\"\u003e\u003cstrong data-start=\"1830\" data-end=\"1849\"\u003eSensory Profile\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"1850\" data-end=\"1999\"\u003e\n\u003cli data-section-id=\"16e1t56\" data-start=\"1850\" data-end=\"1874\"\u003e\n\u003cp data-start=\"1852\" data-end=\"1874\"\u003eAuditory sensitivities\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"8zcypj\" data-start=\"1875\" data-end=\"1897\"\u003e\n\u003cp data-start=\"1877\" data-end=\"1897\"\u003eVisual sensitivities\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"q6op5u\" data-start=\"1898\" data-end=\"1919\"\u003e\n\u003cp data-start=\"1900\" data-end=\"1919\"\u003eTactile preferences\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"17z9g0d\" data-start=\"1920\" data-end=\"1951\"\u003e\n\u003cp data-start=\"1922\" data-end=\"1951\"\u003eMovement and regulation needs\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"2pq089\" data-start=\"1952\" data-end=\"1999\"\u003e\n\u003cp data-start=\"1954\" data-end=\"1999\"\u003eSensory supports that help the child regulate\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"2001\" data-end=\"2026\"\u003e\u003cstrong data-start=\"2001\" data-end=\"2026\"\u003eStrengths \u0026amp; Interests\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"2027\" data-end=\"2092\"\u003e\n\u003cli data-section-id=\"1mzra44\" data-start=\"2027\" data-end=\"2044\"\u003e\n\u003cp data-start=\"2029\" data-end=\"2044\"\u003eChild strengths\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"145vccm\" data-start=\"2045\" data-end=\"2067\"\u003e\n\u003cp data-start=\"2047\" data-end=\"2067\"\u003ePreferred activities\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1751r5u\" data-start=\"2068\" data-end=\"2092\"\u003e\n\u003cp data-start=\"2070\" data-end=\"2092\"\u003eMotivators for therapy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"2094\" data-end=\"2117\"\u003e\u003cstrong data-start=\"2094\" data-end=\"2117\"\u003eAccessibility Needs\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"2118\" data-end=\"2218\"\u003e\n\u003cli data-section-id=\"1gfpafg\" data-start=\"2118\" data-end=\"2142\"\u003e\n\u003cp data-start=\"2120\" data-end=\"2142\"\u003eEnvironmental supports\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"56ey3m\" data-start=\"2143\" data-end=\"2168\"\u003e\n\u003cp data-start=\"2145\" data-end=\"2168\"\u003eMobility accommodations\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"13gqnqn\" data-start=\"2169\" data-end=\"2181\"\u003e\n\u003cp data-start=\"2171\" data-end=\"2181\"\u003eAAC access\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1qsx2w5\" data-start=\"2182\" data-end=\"2218\"\u003e\n\u003cp data-start=\"2184\" data-end=\"2218\"\u003eCaregiver presence during sessions\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"2220\" data-end=\"2258\"\u003e\u003cstrong data-start=\"2220\" data-end=\"2258\"\u003eMedical \u0026amp; Developmental Background\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"2259\" data-end=\"2317\"\u003e\n\u003cli data-section-id=\"hzahgn\" data-start=\"2259\" data-end=\"2270\"\u003e\n\u003cp data-start=\"2261\" data-end=\"2270\"\u003eDiagnoses\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"kgenq8\" data-start=\"2271\" data-end=\"2284\"\u003e\n\u003cp data-start=\"2273\" data-end=\"2284\"\u003eMedications\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1h5kdty\" data-start=\"2285\" data-end=\"2296\"\u003e\n\u003cp data-start=\"2287\" data-end=\"2296\"\u003eAllergies\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"18ovt0c\" data-start=\"2297\" data-end=\"2317\"\u003e\n\u003cp data-start=\"2299\" data-end=\"2317\"\u003ePrevious therapies\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"2319\" data-end=\"2347\"\u003e\u003cstrong data-start=\"2319\" data-end=\"2347\"\u003eSchool \u0026amp; IEP Information\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"2348\" data-end=\"2408\"\u003e\n\u003cli data-section-id=\"vd4pg2\" data-start=\"2348\" data-end=\"2365\"\u003e\n\u003cp data-start=\"2350\" data-end=\"2365\"\u003eSchool services\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"sd5poz\" data-start=\"2366\" data-end=\"2388\"\u003e\n\u003cp data-start=\"2368\" data-end=\"2388\"\u003eEducational supports\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1acof4y\" data-start=\"2389\" data-end=\"2408\"\u003e\n\u003cp data-start=\"2391\" data-end=\"2408\"\u003eRelated therapies\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"2410\" data-end=\"2427\"\u003e\u003cstrong data-start=\"2410\" data-end=\"2427\"\u003eTherapy Goals\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul data-start=\"2428\" data-end=\"2483\"\u003e\n\u003cli data-section-id=\"sc40wy\" data-start=\"2428\" data-end=\"2442\"\u003e\n\u003cp data-start=\"2430\" data-end=\"2442\"\u003eParent goals\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1rqa7pw\" data-start=\"2443\" data-end=\"2456\"\u003e\n\u003cp data-start=\"2445\" data-end=\"2456\"\u003eChild goals\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1800et4\" data-start=\"2457\" data-end=\"2483\"\u003e\n\u003cp data-start=\"2459\" data-end=\"2483\"\u003eCommunication challenges\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2 data-section-id=\"emcxs\" data-start=\"2490\" data-end=\"2519\"\u003ePractice Policies Included\u003c\/h2\u003e\n\u003cp data-start=\"2521\" data-end=\"2607\"\u003eThis toolkit also includes \u003cstrong data-start=\"2548\" data-end=\"2577\"\u003eexpanded policy templates\u003c\/strong\u003e that practices can customize:\u003c\/p\u003e\n\u003cul data-start=\"2609\" data-end=\"3000\"\u003e\n\u003cli data-section-id=\"16ykivv\" data-start=\"2609\" data-end=\"2632\"\u003e\n\u003cp data-start=\"2611\" data-end=\"2632\"\u003eCard on File Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"13g95tr\" data-start=\"2633\" data-end=\"2656\"\u003e\n\u003cp data-start=\"2635\" data-end=\"2656\"\u003eCancellation Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"wx0xt3\" data-start=\"2657\" data-end=\"2680\"\u003e\n\u003cp data-start=\"2659\" data-end=\"2680\"\u003eLate Arrival Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"13pmmgd\" data-start=\"2681\" data-end=\"2704\"\u003e\n\u003cp data-start=\"2683\" data-end=\"2704\"\u003eLate Pick-Up Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"eu050h\" data-start=\"2705\" data-end=\"2738\"\u003e\n\u003cp data-start=\"2707\" data-end=\"2738\"\u003eAttendance Consistency Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"w1oct8\" data-start=\"2739\" data-end=\"2765\"\u003e\n\u003cp data-start=\"2741\" data-end=\"2765\"\u003eMake-Up Session Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"ptrnvx\" data-start=\"2766\" data-end=\"2801\"\u003e\n\u003cp data-start=\"2768\" data-end=\"2801\"\u003eFinancial Responsibility Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"lh8f6b\" data-start=\"2802\" data-end=\"2826\"\u003e\n\u003cp data-start=\"2804\" data-end=\"2826\"\u003eConsent for Services\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"iw7bmf\" data-start=\"2827\" data-end=\"2849\"\u003e\n\u003cp data-start=\"2829\" data-end=\"2849\"\u003eAssumption of Risk\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"ip6qen\" data-start=\"2850\" data-end=\"2883\"\u003e\n\u003cp data-start=\"2852\" data-end=\"2883\"\u003eHIPAA Privacy Policy Template\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1y4kt96\" data-start=\"2884\" data-end=\"2909\"\u003e\n\u003cp data-start=\"2886\" data-end=\"2909\"\u003ePhoto \u0026amp; Video Release\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1itkads\" data-start=\"2910\" data-end=\"2939\"\u003e\n\u003cp data-start=\"2912\" data-end=\"2939\"\u003eIncident Reporting Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"1dmax3a\" data-start=\"2940\" data-end=\"2967\"\u003e\n\u003cp data-start=\"2942\" data-end=\"2967\"\u003eClient Dismissal Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003cli data-section-id=\"ozm05j\" data-start=\"2968\" data-end=\"3000\"\u003e\n\u003cp data-start=\"2970\" data-end=\"3000\"\u003eScheduling \u0026amp; Waitlist Policy\u003c\/p\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp data-start=\"3002\" data-end=\"3115\"\u003eThese policies help establish \u003cstrong data-start=\"3032\" data-end=\"3115\"\u003eclear expectations for families and consistent procedures within your practice.\u003c\/strong\u003e\u003c\/p\u003e\n\u003ch2 data-section-id=\"96tfss\" data-start=\"3122\" data-end=\"3148\"\u003eWho This Toolkit Is For\u003c\/h2\u003e\n\u003cp data-start=\"3150\" data-end=\"3180\"\u003eThis template is designed for:\u003c\/p\u003e\n\u003cp data-start=\"3182\" data-end=\"3375\"\u003e• Speech-language pathologists starting a private practice\u003cbr data-start=\"3240\" data-end=\"3243\"\u003e• Pediatric private practice owners\u003cbr data-start=\"3278\" data-end=\"3281\"\u003e• SLPs updating their intake process\u003cbr data-start=\"3317\" data-end=\"3320\"\u003e• Clinics wanting a more neuroaffirming intake system\u003c\/p\u003e\n\u003ch2 data-section-id=\"t60x0l\" data-start=\"3382\" data-end=\"3403\"\u003eFully Customizable\u003c\/h2\u003e\n\u003cp data-start=\"3405\" data-end=\"3472\"\u003eThe template is designed to be \u003cstrong data-start=\"3436\" data-end=\"3454\"\u003efully editable\u003c\/strong\u003e, allowing you to:\u003c\/p\u003e\n\u003cp data-start=\"3474\" data-end=\"3641\"\u003e• add your practice name and branding\u003cbr data-start=\"3511\" data-end=\"3514\"\u003e• adjust policies to match your procedures\u003cbr data-start=\"3556\" data-end=\"3559\"\u003e• remove or add sections as needed\u003cbr data-start=\"3593\" data-end=\"3596\"\u003e• customize formatting to your clinic style\u003c\/p\u003e\n\u003ch2 data-section-id=\"mtepoj\" data-start=\"3648\" data-end=\"3687\"\u003eWhy This Toolkit Helps Your Practice\u003c\/h2\u003e\n\u003cp data-start=\"3689\" data-end=\"3733\"\u003eA structured intake and policy system helps:\u003c\/p\u003e\n\u003cp data-start=\"3735\" data-end=\"4034\"\u003e• create a smoother onboarding process for families\u003cbr data-start=\"3786\" data-end=\"3789\"\u003e• gather meaningful clinical information before the first visit\u003cbr data-start=\"3852\" data-end=\"3855\"\u003e• reduce confusion about scheduling and cancellations\u003cbr data-start=\"3908\" data-end=\"3911\"\u003e• set clear expectations for attendance and communication\u003cbr data-start=\"3968\" data-end=\"3971\"\u003e• save time when building or updating your practice paperwork\u003c\/p\u003e\n\u003cp data-start=\"3735\" data-end=\"4034\"\u003e \u003c\/p\u003e\n\u003cp data-start=\"3735\" data-end=\"4034\"\u003eImportant Disclaimer\u003c\/p\u003e\n\u003cp data-start=\"4066\" data-end=\"4210\"\u003eThis template is provided for informational purposes and is intended as a customizable resource for speech-language pathology private practices.\u003c\/p\u003e\n\u003cp data-start=\"4212\" data-end=\"4461\"\u003eIt \u003cstrong data-start=\"4215\" data-end=\"4277\"\u003edoes not constitute legal, financial, or accounting advice\u003c\/strong\u003e and has not been reviewed by an attorney or accountant. Practices are responsible for reviewing and modifying policies to ensure compliance with local, state, and federal regulations.\u003c\/p\u003e","brand":"Lead with Luisa","offers":[{"title":"Default Title","offer_id":45059206545455,"sku":null,"price":37.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0738\/4331\/0639\/files\/SpeechPracticeIntakeandPoliciesTemplate.png?v=1773703530","url":"https:\/\/leadwithluisa.com\/products\/private-practice-intake-and-policies-template","provider":"Lead with Luisa","version":"1.0","type":"link"}