Resonate Voice and Speech Services LLC

Who would be receiving care?

Someone else

Your info

First name

Last name

Phone

Name you go by

Date of birth

Gender

State

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Reason for care

What is the reason for seeking care?

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Administrative

Referral source

How did you hear about Resonate?

Billing & Payment

Payment method

We only participate with Medicare insurance and are considered out-of-network for all other plans. Superbills can by provided for out-of-network coverage reimbursement.

Client Preferences

Client availability

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Mid-day (11am-2pm) Afternoon (3pm-5pm) Evening (5-7pm) Tuesdays Thursdays

Is there anything that the practitioner needs to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

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If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice.