NOTE: If START and END times vary per day, please define.
i.e. Parking Instructions, Check in with the front desk
DOB: This information is helpful for Associates to find consumers, as well as assists them in preparing for assignment.
i.e. Voices for themselves, Uses ASL, Blind, etc.
ie: Medical- OBGYN appointment for consumer who is 8 monthes pregnant, Master's level coursework for tort law
i.e. Referral, Google Search
By clicking SUBMIT, you are agreeing to schedule services according the authorization we have on file for your organization. If you do not already have a completed authorization on file, one will be sent to you in order to continue the scheduling process.
*If you have technical difficulty with submission of this form, please contact reservations@mtapractice.com ASAP.