Client Information Form

QTF Interior Banner 3 Mobile - Client Information Form For Speech Language Pathologist

Client Information Form for SLP

We understand you are interesting in determining if insurance will cover a QuickTalker Freestyle communication device for your client. AbleNet’s staff of medical benefits analysts will contact your client’s insurance company and discuss the possibility of coverage for the QuickTalker Freestyle communication device. The medical benefits analyst will let you know within 1-business day whether the device is a covered benefit under your client’s current insurance package.

Download the Medical Release for your client to sign. You will need to submit your client’s insurance card(s). You can submit the card(s) using this secure link now or this link will be available after you submit this form.

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