Get Ddd-1151a - Augmentative Alternative Communication (aac) Referral Packet. Augmentative Alternative

The DDD-1151A - Augmentative Alternative Communication (AAC) Referral Packet is an essential document aimed at facilitating the evaluation and training for augmentative communication devices. This guide provides step-by-step instructions to support users in accurately completing the form.

Follow the steps to successfully complete the AAC Referral Packet.

1. Press the ‘Get Form’ button to access the AAC Referral Packet. This will allow you to open the document in your preferred editing tool.
2. Fill out the 'Member Information' section, including the name, AHCCCS or Assists ID number, age, date of birth, address, and contact information for the parent or guardian.
3. In the 'ISP Information' section, attach the most current Individual Support Plan (ISP). If unavailable, request this document from the Support Coordinator.
4. Provide insurance information by including a clear copy of the member's third-party payer card or Medicare Health Plan ID card, both front and back.
5. Select the preferred evaluator by checking the appropriate box, ensuring that the choice is made by family members.
6. Complete the Communication Skills Questionnaire (CSQ) section, and ensure it is filled out by a certified Speech-Language Pathologist, with detailed descriptions where necessary.
7. Return the completed packet to the family for signatures and office notes from the face-to-face physician visit.
8. The family submits the signed Packet back to the Speech-Language Pathologist or the Support Coordinator for final submission via email.
9. Ensure that the packet is fully completed, as any missing information may delay the process.

Complete your documents online today to facilitate timely access to the necessary Augmentative Alternative Communication resources.