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Edward D. Mysak Clinic for Communication Disorders
New Client Packets
Diagnostic and therapeutic services are provided for disorders of speech, language, hearing, voice, and swallowing resulting from varied etiologies including, but not limited to: autism, dementia, developmental delays, motor speech disorders, stroke, and traumatic brain injury.
If you are interested in receiving services at the Mysak Clinic, please complete the appropriate information packet (adult or pediatric) located in the sidebar to the right and return these forms to the Clinic. You may e-mail the forms firstname.lastname@example.org, mail the forms to the address at the bottom of this screen, or drop them off in person. Please do not fax these confidential forms.
Please note that the Mysak Clinic does not accept insurance, Medicaid or Medicare. Clients who receive therapy at the Mysak Clinic are responsible for payment. The Mysak Clinic offers a sliding fee scale for those individuals who cannot afford the full cost of therapy.