Filling out a Request to Pay Provider form? This should help.
Service Provider: please name your therapist (we are all RASP providers)
Total amount: estimate the number of weeks you will attend x 1hr. (e.g. $120 or $150 for home visits; $60 or $80 for Therapy Assistants/SLPAs; $90 per group session)
Please be sure to SIGN the form.
Any questions still? Ask us- we're happy to help!