Don't Let the Threat of Legal Nightmares Ruin Your Private Practice Dreams!

Get Legal Protection for Your SLP Private Practice

(Without the Cost of Having a Lawyer on Speed Dial!)

SLP Private Practice Forms

30+ customizable and lawyer-reviewed forms that add a layer of legal protection and take the stress out of starting your SLP private practice.

Want all 30+ forms (including any future forms) for just $347?

Yes, I need these forms!

As an SLP, having all your ducks in a row is SO important to reach your goals…

You want to help each of your clients make meaningful progress

You want expectations to be understood and met at every step.

You want to get paid on time and in full without any confusion.

You want to be seen as a go-to care provider in your community.

You want to build strong relationships that bring in new referrals.

I bought Jena's forms a week before my first private client, and I'm so glad I did!

"It saved me at least of months-worth of work! I'm a perfectionist, and wanted to make sure I had everything in place for that client. Two years later, I still use them. Honestly, they're a steal!"

Claudia D., SLP

I am so grateful for the time and money The Clinic Forms saved me!

"The amount of time it would've taken me to do these on my own and the amount of money I would have spent on a lawyer to review them would have been astronomical. I would buy them again in a heartbeat! 

Tamiko T, SLP

But when those new referrals come in and they want to work with you privately, so do all the “what ifs…”

😱 “What if something goes wrong and I get sued?”

😱 “What if my other clients decide to abandon me?”

😱 “What if I end up losing my license to practice?”

😱 “What if I accidentally leave my family vulnerable?”

😱 “What if I lose everything practically overnight?”

😱 “What if I end up in SLP jail?”

These are the thoughts that leave so many SLPs feeling paralyzed about starting their own private practice, and they’re not being overly dramatic.

These things do happen all the time to well-meaning and highly-skilled SLPs --

Imagine the sense of pride, professionalism, and peace that comes with having forms like these…

    • Ready to fill out before your first session with a new client
    • Easy to email and sign electronically or print and file away
    • Customized with your name, logo, and preferred language
    • Clearly establishing your policies & procedures in advance
    • Giving your business an additional layer of legal protection
Yes, I need these forms!
Having the right forms for your private practice should be the

first and easiest investments you make in your business...

...So that at every stage of your private practice journey, you’ve got an extra layer of legal protection covering you!

INTRODUCING...

SLP Private Practice Forms

These SLP Private Practice Clinic Forms were created by and for SLPs (with the help of a lawyer) and can provide you with additional protection and peace of mind that can’t be found ANYWHERE else.

Yes, I need these forms!

don't just take my word for it...

Here's a list & description of all the forms included:

 LEGAL PROTECTION FORMS

While these forms are not a substitute for professional liability insurance (you do have that, right?) these forms are your first line of defense that are an essential layer of protection in any private practice.

Forms Included:

  • The General Acknowledgement of Forms Form is a first-step given to the client or family member to state that they have read, understood, and agreed to all statements and policies outlined in the forms that you present.
  • The Notice of Privacy Practices Form clearly states the responsibilities of the private practice, the uses and disclosures of protected health information, and the patient's rights to privacy. 
  • The Acknowledgement of Receiving the HIPAA Form is a form for the client to sign that acknowledges that they have seen the HIPAA notice and understand its contents.
  • The Acknowledgement and Assumption of Risk Form can supplement (but does not replace) your professional liability insurance and should be used by clinicians who use equipment that could accidentally cause injury or harm.
    This form is also ideal to add in your own language to cover policies and rules specific to your private practice, as well as state and local laws, regarding COVID-19.
  • The Consent for Services Form gives permission to the private practitioner to complete an evaluation and render appropriate therapy services.

CLINICAL DOCUMENTATION FORMS

From day one, these forms can help you gather much-needed information about your clients to create a treatment plan and document the journey as you progress toward their goals at every step of the way.

Forms Included:

  • The Child Intake Form allows you to collect information about the client's developmental, educational, vocational, speech/language, cognition, feeding/swallowing etc. history. (Ideally, this form is sent to the client in advance and have it filled out and returned before their evaluation.)
  • The Adult Intake Form allows you to collect information about the client's developmental, educational, vocational, speech/language/cognition/feeding/swallow etc. history.(Ideally, this form is sent to the client in advance and have it filled out and returned before their evaluation.)
  • The Session Progress Notes that can be completed after each session with a client which can include your session number, insurance information, NPI / License Number, etc. Having this documentation is critical in the (unlikely but possible!) event of a lawsuit so that you can clearly communicate what happened in your sessions. (Ideally, this form is sent to the client in advance and have it filled out and returned before their evaluation.)
  • The Evaluation Report Template that you can modify to meet the exact needs of your practice and use to report your clinical evaluation.
  • The Progress Summary Report Template that you can modify to meet the exact needs of your practice and use to report your client progress towards goals over a specified period of time.

PAYMENT FORMS

Who doesn’t want help getting paid in full and on time? Use these forms to detail your procedures and policies while streamlining your payment systems to ensure a better experience for you and your clients!

Forms Included:

  • The Attendance Agreement / Cancellation Policy that clearly outlines the attendance, tardiness, cancellation, bad weather, illness, etc. policies, as well as any fees that the client may be responsible for as a result of a missed session.
  • The Credit Card Authorization Form that allows you to bill their credit, debit, or FSA card for services rendered. This includes doing so on card readers, such as Square.
  • The Attendance and Record of Payment Form provides a record of all attended sessions (as well as who the payor source for the session was and whether the session was paid or if the payment is pending). Having the client, parent, or responsible party sign and acknowledge that they attended the session encourages payment on the date of service and is useful in the (unlikely but possible!) event of a disputed charge.
  • The Payment Policy and Fee Schedule is your place to detail the rates for your services and explain the client's financial responsibility and payment options and terms. Think of this like the legal “menu” of your offerings and the price associated with each service.
  • The Superbill Template provides you with a way to collect payments privately and gives your clients and their families an opportunity (although not a promise) to get reimbursed through their insurance in the form of a coded receipt.
  • The Health Insurance Verification Form is useful when speaking to your client's health insurance company(ies) to verify their coverage and gather information to help you get paid. 
  • The CMS 1500 Form is the standard claim form used by non-institutional providers to bill Medicare for services and/or equipment. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment.

CLIENT AND FAMILY COMMUNICATION FORMS

Although these forms are used on an as-needed basis, you will be well prepared when that need arises -- which will put you, your clients, and their families at ease with clear expectations and communication.

Forms Included:

  • The Communication Preference Form will allow you to collect contact information for your clients, and more importantly, get permission to contact them via various methods (including text message).
  • The Record of Client Contact Form can be used to keep track of emails, phone calls, meetings, appointments, and other forms of communication you have with your clients and their family members.
  • The Consent for Observation Form is used to get consent FOR THE PRIVATE PRACTITIONER to observe a client in another setting, such as a daycare, school, place of employment, or other environment as needed with space to detail the location.

    This form DOES NOT cover the client to be observed at your private practice by a graduate student, intern, or other staff / guests in your private practice.

SCREENING AND TELEPRACTICE FORMS

With telepractice becoming a more popular form of treatment, it’s important to know that most forms were NOT created with this in mind. Having a set of forms for virtual practice is critical to your protection.

Forms Included:

  • The Screening Permission Forms provide consent from parents for you to conduct a screening with their child (to see if they are within normal limits or should be evaluated further). This is required since they are minors and cannot give consent.
  • The Telepractice Consent Form must be filled out by your clients before you begin providing them with telepractice services. General practice forms that are not specific to telepractice will not protect you here!

OTHER PROVIDER & CARE TEAM COMMUNICATION FORMS

Having your communication in compliance is a must! These forms can help facilitate the exchange of information and referrals between you and other care providers as mandated by HIPAA.

Forms Included:

  • The Consent to Exchange, Obtain and Release Information Form allows you to share and receive information with other professionals for evaluation and treatment planning purposes.

    Do not contact or share information with other providers until you have written permission to do so, as this would be a HIPAA violation.
  • The Fax Cover Sheet might sound archaic, but faxing is still the gold standard for communicating with physician offices and having the right cover sheet can provide additional protection from inadvertent exposure of your documents. 
  • The Physician Referral Form provides an easy way to get referrals from physicians and specialists. It’s a best practice to have these on hand, and depending on the payor source, it may be required. 

 

TESTIMONIAL & MARKETING FORMS

These forms are the gift that keeps on giving and can help you gather important information that can be used to promote your private practice and attract new clients in a powerful and professional way.

Forms Included:

  • The Client Testimonial Permission Form will help you gather important “social proof” in the form of testimonials from happy clients and their families to use in powerful marketing tools that will attract new clients. 

    Do not contact or share information with other providers until you have written permission to do so, as this would be a HIPAA violation.
  • The Fax Cover Sheet might sound archaic, but faxing is still the gold standard for communicating with physician offices and having the right cover sheet can provide additional protection from inadvertent exposure of your documents. 
  • The Physician Referral Form provides an easy way to get referrals from physicians and specialists. It’s a best practice to have these on hand, and depending on the payor source, it may be required. 

HIRING FORMS

As your private practice grows, so will your need to hire new support. From independent contractors to part and full time employees, these forms will help you create (and contract!) a dream team in your business! It is recommended that these forms be used as time-saving blueprints that are modified to meet the needs of your private practice and reviewed by your own attorney in accordance with your state and local laws.

Forms Included:

  • The Independent Contractor Agreement can be used to outline the roles, responsibilities, compensation, and more for your independent contractors.
  • The Sample Employee Contract can be used to draft the roles, responsibilities, payment, benefits, and more that you plan to offer.
  • The Sample School Contract can be used to provide speech therapy services to local schools through your private practice.

PLUS this exclusive

BONUS BUNDLE

when you buy now

Customizing Your Forms: A Step-by-Step Video Tutorial

Watch this tutorial to find out exactly how easy it is to add your own name, address, logo, and more to these forms so they fit in with your private practice seamlessly. We’ll even cover how to adapt the language to fit your needs and preferences as a private practitioner.

The Private Practice Risk Minimizer

Having these Private Practice Clinic Forms is an essential layer of protection that MUST come early when starting your business -- but they aren’t the only form of protection you’ll want to consider. This PDF will break down all of “the legal stuff” into plain English.

The Organized Private Practitioner To-Do Lists

No matter where you’re at in your private practice journey, the best time to get organized is right now! These daily, weekly, and monthly to-do lists were created with the input of multiple SLPS and will help you keep all your ducks in a row as you grow your biz.

Sharing what’s included was a real mouthful...

When you purchase The Private Practice Clinic Forms right now, you’ll get instant access to:

  • 10 beginner forms (a $997 value)
  • 20 advanced forms (a $1997 value)
  • Customizing Your Forms Tutorial (a $297 value)
  • The Risk Minimizer (a $197 value)
  • The Organized Private Practitioner To-Do Lists  (a $197 value)
  • 10 beginner forms (a $997 value)

Total Value = $5,179 

Your Investment: $347

Want to reserve your bundle before the price goes up?

 

Sign me up - I want legal protection!

 

"YOUR forms saved me time and gave me the confidence that I am not missing anything and have all my ducks in a row. Thank you!"

 

Ayelet Marinovich, M.A. CCC-SLP, Owner/Speech-Language-Pathologist, San Francisco Bay Area, CA Strength in Words

"The lawyer who is helping me set up my business was impressed with how well done the forms were.

I found the forms very easy to edit and they were incredibly time-saving.

 

Emily Cohen, MA, CCC-SLP, Owner/Speech-Language-Pathologist, Austin, TX, Tandem Speech Therapy

"I periodically update all of my forms and was very pleased to find your very professional-looking forms. Great Job.

 

Dr. Judith Belkn, CCC-SLP, CCC-A, Owner/Speech-Language-Pathologist & Audiologist, Lake Oswego, OR, Center forLearning & Communication Needs

Don’t put off your dream of owning a private practice because you’re afraid of a legal nightmare!

A few years ago, I decided to survey 100 SLPs to find out what was really holding them back from starting their private practice.

I expected the answers to be not enough time or not enough knowledge -- but what most people said shocked me: 

Most SLPs avoid starting their private practice out of fear.

(More specifically, the fear of failure and losing everything if something potentially went wrong.)

The idea that there were so many SLPs who pumped the brakes on starting a business that would NOT ONLY give them more flexibility, freedom, fulfillment, financial abundance, family time, and fun…

BUT ALSO could transform the lives of so many people in their communities?

Well, that just broke my heart.πŸ’”

 you might have seen me around before...

So I decided to team up with a lawyer to create dozens of forms for SLPs that are starting their private practice and need to add a layer of legal protection.

Since then, I’ve helped over 1,600 SLPs start successful private practices without losing any extra sleep at night thanks to these forms. (That includes SLPs who are just getting started seeing private clients on the side and seasoned private practice owners looking for a more robust collection of forms.) In other words… No matter where you’re at in your private practice journey, if you’re looking for customizable lawyer-reviewed forms, I can help you too!

Want all 30+ forms (including any future forms) for just $347?

Oh yeah! I need the legal protection.

These forms were made specifically for SLPs who are just getting started in their private practice and want to minimize their risk.

But you might be surprised to find out how many seasoned SLPs buy these forms to complete or upgrade what’s already in their physical - or digital-  filing cabinets!

With the help of a lawyer, these forms have been made by and for SLPs. 

And really, no one else!

(Although I have had a few OTs and social workers buy these in the past.)

So now that we’ve cleared that up and you know exactly who these are for…

Here are the next steps you need to take to get these forms for your private practice today!

Enter your email address to reserve your forms and lock in the low price that you see today.

You'll be taken to a payment page where you can securely enter all of your information.

Check your inbox for an email with instant access to your forms and bonuses in our Members Area.

Once you’ve gained access to these forms, you can customize them to fit your needs and add them to your website, keep copies in your office, or send them to clients through email or snail mail.

I'm ready to buy the forms!
FREQUENTLY ASKED QUESTIONS

FAQ's

Still not sure if you need these forms right now?

One of the worst mistakes you can make as an SLP is putting off legal protections until it’s too late. 

The unfortunate reality is that things can (and do) sometimes go wrong -- even in first sessions

If you think investing in legal forms is expensive now, that’s truly nothing compared to what legal fees might be waiting on the other side of an accident.

(And that’s not even taking into account a worst-case-scenario where losing a case could mean losing your license and so much more!)

This isn’t just about the money…

It’s about the time, confidence, peace of mind, legitimacy, and ease that you’ll be enjoying when you choose to make “the legal stuff” simple.

These forms were made specifically for SLPs to customize and adapt in a matter of minutes -- and nobody else!

If you’re an SLP who has started seeing private clients or plans to then you need these forms NOW.

GRAB THE FORMS NOW

there is a lot included in the form bundle...

When you purchase The Private Practice Clinic Forms right now, you’ll get instant access to:

  • 10 beginner forms (a $997 value)
  • 20 advanced forms (a $1997 value)
  • Customizing Your Forms Tutorial (a $297 value)
  • The Risk Minimizer (a $197 value)
  • The Organized Private Practitioner To-Do Lists  (a $197 value)
  • 10 beginner forms (a $997 value)

Total Value = $5,179 

Your Investment: $347

Want to reserve your bundle before the price goes up?

 

Sign me up - I want legal protection!

 

Privacy Policy   |    Terms of Service  |  © 2021 Independent Clinician

Refund Policy: Due to the digital nature of this products, there are no refunds after purchase.

Legal Disclaimers: While I am experienced in researching, deciphering, and writing about HIPAA rules and regulations—as well as the associated legalese—I am not a lawyer, nor do I have any HIPAA certifications. I am simply providing professional assistance through proven strategies and resourceful features. As such, we make no warranties and the contents of these forms shall not be construed as legal advice. If you have specific questions about HIPAA rules, regulations, and laws, please speak to a legal professional or certified compliance expert.

LEGAL INFORMATION: ALL RIGHTS RESERVED:
 You do not have any rights to share, sell, distribute, republish, transmit in any form, or profit from these forms. You cannot claim any type of ownership. All rights are reserved by the author, Jena H. Castro-Casbon, MS CCC-SLP. DISCLAIMERS: 
All information contained within these forms is strictly the views represented by the author, at the time of publication. Said author can and does reserve the right to add to, change, alter or update the thoughts and opinions stated herein. Every attempt has been made to accurately substantiate all information in these forms. However the author makes no warranty to nor does she take responsibility for any errors or exclusions that may be contained within. The author does not offer legal or financial advice and the contents of these forms must not be construed as such. It is recommended the customer contact the appropriate qualified professional for advice in these and any other areas should it be needed. It is the responsibility of the customer to know and adhere to any local or organization (ASHA, AOTA, APTA) laws regarding the conducting of business in this specialized field. Users of these forms are advised to do their own due diligence when it comes to making business decisions and all information, products, services that have been provided should be independently verified by your own qualified professionals. By using these forms and reading information in the Member Area, you agree that myself and my company is not responsible for the success or failure of your business decisions relating to any information presented.

Liability: The author, Jena H. Castro-Casbon, MS CCC-SLP is fully excluded from any liability that may arise out of the use or misuse of any information contained within these forms or content on this site.