Welcome to the Boca Raton Speech and Rehab Center’s Registration Page
You have been provided with a password to access our facilities registration materials. Please print out the documents, complete them and return them by fax to (561) 416-9075. You may present the original documents on the day of the evaluation. If you do not have a fax, let BRSRCI know. Depending on the type of evaluation, you will be advised to either mail them to our facility or bring the completed paperwork on the day of the evaluation. If you have any questions, please feel free to contact our center.
Medicare Patient
Speech and Swallowing Packet : 232KB PDFVoice Packet : 244KB PDFChild
Speech and Language Packet : 252KB PDFVoice Packet : 448KB PDFStuttering Packet : 476KB PDFPediatric Swallowing Packet : 228KB PDFCommunication Cognitive Packet : 320KB PDFAdult
Speech, Language, and Swallowing Packet : 248KB PDFVoice Packet : 448KB PDFStuttering Fluency Packet : 476KB PDFAccent Modification/Corporate Speech Packet : 608KB PDFCommunication Cognitive Packet : 312KB PDFTransgender Packet : 288KB PDF