For referring providers
Refer a patient in one fax
Pediatric speech-language pathology for ages birth–21. Fax the order. We contact the family within one business day and send a courtesy update back to your office.
Brittany Furnari, MS, CCC-SLP · Birth–21 · Greeley
Provider Referral Fax
(720) 798-6936
Phone (720) 798-6930How to refer
Fax the signed order to our referral fax
We contact the family within one business day
We send a courtesy update to your office
Physician order
Download the fillable PDF, or print this page and fax it to the number above.
Physician order
Front Range Speech Therapy
Speech-language pathology evaluation and treatment
4645 18th St, Ste #200, Greeley, CO 80634
P (720) 798-6930
F (720) 798-6936
Fax to (720) 798-6936. Attach a recent visit note if available. We contact the family within one business day and send a courtesy update to your office.
Download the fillable PDF, or print this page and fax it to the number above.
Download formWhen to refer
- Not babbling by 12 months
- No words by 16 months
- Not combining words by 24 months
- Speech that familiar listeners struggle to understand
- Stuttering that persists or comes with tension
- Hearing loss, cochlear implant, or BAHA
- Suspected childhood apraxia of speech or social-communication concerns
Insurance we work with
We verify benefits before the first visit for clients birth through 21.
Quick answers
No. Families can contact us directly. Some plans, including Health First Colorado, need a written order from an MD, DO, PA, or NP for coverage. If you already have concerns, faxing the order now saves the family a second step.
Patient name, date of birth, parent phone, reason for referral, and your NPI and signature. A recent visit note helps. Our one-page order has the fields Colorado Medicaid needs on the claim.
Yes. We work with Health First Colorado, CHP+, and most major commercial plans for clients birth through 21. We verify benefits before the first visit.