WWYD about this? Speech therapy in the PS vs. private therapy?

[melissel]

DD6 needs speech therapy for a frontal lisp that isn't going to go away on its own. According the federal ChildFind program guidelines, she's entitled to speech therapy through the school system. However, when I called the school district liaison, they knew nothing about HSed/private-schooled children being eligible for the program and insisted she would have to enroll in the school district to receive services. I finally said "Never mind, thanks for your time" and hung up, not surprised but thoroughly irritated. (

 

There's a part of me that believes that we should push for what we're entitled to--after all, we pay a shocking (but cheap for the our state!) $7,500 a year in property taxes, and most of that goes to the school system we don't use. However, pushing for that will get us on a radar that I don't ever want to be on. In addition, there are two legislators in NJ who have been very vocal about pushing hard for major homeschool oversight legislation in the coming year in the wake of another case where parents who claimed to be HSing kept their children home and ended up killing them. I think it's the third in the state in recent years, and one of the legislators (the senior one) has been fomenting HS oversight activity just about every other year for the past 8 years or so. The teachers' union is extremely strong in NJ, and she's their biggest champion.

 

SO! I am very paranoid that we might end up being the spark that ignites some kind of powder keg. I know that the chances of that are slim, but HSing, while popular, is very under the radar in NJ. I would very much hate to be the one who brings it any kind of unwanted attention. Coupled with that, our insurance does cover private therapy, with a co-pay of $35 per session. We really don't have the money to pay even that much out of pocket right now, but it could be scrounged up if necessary.

 

WWYD? Fight and risk the exposure, or just avoid the whole mess pay out of pocket for (possibly more efficient) private therapy? Also, can anyone weigh in on how long therapy for a frontal lisp might take? She has sucked her thumb since before birth and actively since then, so the tip of her tongue protrudes to cause the lisp. I've tried to work with her at home, but I have no real idea what I'm doing or how to make it fun, and we're pretty much just annoying each other at this point *sigh*

 

TIA for any thoughts you may have!

[Whereneverever]

First- a question. How is the school district's reputation for therapy? Do they generally do a good job?

 

If so, I'd push it.

 

If not, I'd explore my options through insurance.

[melissel]

First- a question. How is the school district's reputation for therapy? Do they generally do a good job?

 

If so, I'd push it.

 

If not, I'd explore my options through insurance.

 

I have absolutely no idea. The only friends we have in town are either HSers or have not been in the district's therapy programs.

 

ETA: Thank you for the train of thought--I'll see what I can find out from the few PSers we know :D

Edited November 8, 2011 by melissel

[sassenach]

I just researched this, because I need to have my 7yo evaluated. Are you registered as a private school in NJ? Here in Cali, there are no home schools, only very, very small private schools. Under IDEA, there are no specific provisions for home schools, but there are for private schools.

 

The local district is Federally mandated to evaluate every child. However, they are not obligated to treat every child (not within their district). Every district has to set aside a certain percentage of their IDEA funds to treat private schooled students. The amount is different for every district, based on an algorithm that plugs in a lot of district specific numbers. Once they have spent that money, they are not obligated to spend more. But once again, that's for private schools. There is no mandate for home schools.

 

Times are tight. Most districts are not going to be willing to spend more than they have to. If you want to pursue it, as for the evaluation again. Then see how pliable the administrators are.

 

In our case, even though I have a relationship with the top administrator (because my special needs son attends in the district), I'm still not sure that we're going to get anything more than an eval out of this. My goal is to get an idea of how serious the issue is and then make some decisions about how we will proceed.

 

Note: New Jersey may have its own laws in this matter, so check with your state home school association.

 

Also, another possible path would be through a homeschool charter. As has been said many times before, charters are public schools. When you enter a charter, you fall back under IDEA's mandatory treatment bracket.

[Avila]

Another option is to see if any universities close to you have speech clinics. Most universities that offer M.S. Degrees in speech pathology have clinics for the students to work with real patients. The clinics are supervised by practicing, licensed therapists, and the students are graded, so they work pretty hard for your child. They usually do not take insurance, but since it is part of an educational program, the fee is often a lot lower than your co-pay would be. We paid $10 a session.

 

My middle DD took speech therapy at one of these clinics. The quality was a LOT better than at our school district.

 

Our only issue was a long waiting list, but we were able to bypass it. The waiting list was for the evaluation, and not the therapy. So we paid for a private evaluation that they accepted and took our therapy with them.

 

Anyhow, this can work out really well, if you can find something close.

 

ETA: there is also a speech program to do at home offered by NATTHAN that you might want to look at while you work something else out.

Edited November 8, 2011 by Asenik

[Ellie]

If there's any way you can do it privately, then that's what I'd recommend. Just because you're entitled to services at the public schoold doesn't mean it's a good idea.

[Virg]

Just my 2 cents and may not apply to you but ime school speech therapy is worthless. My children have been in it for 10 years (including the early childhood education and early intervention). When I was finally able to take them to a private speech therapist and have them assessed at the local children's hospital by a team, I was told that pretty much everything that had been done was a waste of time.

 

Your school district could be much better though :)

[All4one]

Two of my children are presently in speech therapy. We decided to go the private route because of the application process, wait time, and group setting involved with ps therapy. I was told it might take a year to get them in because of funds being cut and priority placement. Our insurance doesn't cover this since it's not considered a medical issue so we're paying completely out of pocket.

Your initial consult with a SLP should be covered by insurance if you get a referral. Then they can give you an idea of how much therapy your child will need. Our SLP said they were highly stimulable and should only need a few sessions. After they learn some strategies for making proper letter sounds we can work on them further at home.

HTH

[stephanier.1765]

If there's any way you can do it privately, then that's what I'd recommend. Just because you're entitled to services at the public schoold doesn't mean it's a good idea.

 

:iagree: My youngest went to PS speech therapy from the time he was 2 to 6. We couldn't hear any noticeable improvement in his speech. Part of the problem with PS therapy is that it's usually done in groups which means little one on one time with your child. Finally I pulled him out and investigated private therapy. Big difference! The $30 co-pay was worth every penny even though those pennies were very tight. Because it was one on one she could tailor his therapy to his likes and his motivators. For her he worked hard. Honestly, moving him to private therapy was one of the best parenting decisions we ever made.

[joannqn]

My son received speech therapy through the public school system here in Washington. He started out going to preschool there when he was 3 because he had a whole host of needs well beyond simple speech therapy. While there, he participated in all of the usual special ed preschool activities (he had a wonderful teacher) and was also pulled out once a week for one-on-one speech therapy with the SLP. We found the cause of his trouble, and by the time he was ready for kindergarten he had caught up academically. He still needed speech therapy, though. For the next school year, he had a once a week one-on-one private appointment with the school's speech therapist. She was supportive of homeschooling, so that made it that much more pleasant.

 

Yes, he did have to enroll in public school to obtain the speech therapy, but not enroll as in going full time. It was only an enrollment for the therapy. They need the student's enrolled to get the funding for the therapy.

Edited November 8, 2011 by joannqn

[cheryl h]

If it's anything like the school system here, I would go through private practice. I have heard from other moms in town that have had their kids in ps that they only do group therapy. Your kid is grouped with others with similar issues and do group speech excercises once a week. I don't see that as effective from any angle. We have tried to get dd13 speach therapy in our district and was denied, even though she got therapy in a neighboring district from a very qualified therapist (Phd). The therapist in our district was not friendly at all, in fact, very anti-hs. She tried to tell me dd13 didn't have a problem at all and that the last therapist was waisting tax payer dollars. It's a bi-lateral lisp, severe enough people have made fun of her...and she told us there isn't an problem. We would have to drive 35 min. both ways to a private practice, likely 2-3 times a week, to get to a private therapist. And the bottom line is that dd13 doesn't want to fix it, she doesn't think it's that bad.

 

I know what I have already said may not be of much help, but the bottom line in your success is going to be how willing your dc is to work on it. I would see a private therapist for analysis and see if they can make a plan that works for you financially. It sounds like your district isn't willing to help you, and that may affect the attitude of the therapist making it not the best treatment environment for your dc.

[wapiti]

Our district does not provide speech therapy for homeschooled students.

 

Moreover, our district rarely provides speech therapy for a lisp alone for students attending district schools. (ask me how I know :glare:. my current K-er...)

 

FWIW, for my two lisp kiddos, I bought this book to start working at home. I've had various kids in various stages of speech therapy for nearly a decade. I'm trying to decide whether to homeschool my ds8s next year, but one of them is on an IEP for speech right now - I'd have to line up private therapy, which, as you know, is costly. I may do it anyway because I'm not sure what progress he's really making at school.

[snickelfritz]

My dd has a lisp from her tongue thrusting out between her teeth. We had her evaluated right at a year ago, when she turned 5. She started therapy right after the new year, so it's just shy of a year into therapy. She gets a private, 25 minute, therapy session twice a week at a university speech pathology program. They take off whenever school is on break, but she did go through most of the summer.

 

When she started, it was with beginning s sounds. They proceed through harder and harder word combinations. She's still in therapy, but has been working on saying s-blend words mid-sentence (which is harder for them, because the s sound is now blended and mixed in the middle of other words....not as focused on.)

 

They are also evaluating her this week to see what other sounds she needs to work on. The s lisp was the most prominent-and the sound that should have been mastered the youngest- but she also doesn't pronounce r's. That's a later skill, so they hadn't touched it until they got improvements in the s sound.

 

Anyway, it all means that the s sound still isn't perfect, but she's made huge strides and is incorporating the correct sound into her casual language. I'm hoping that she can stop speech by the time they break for summer.

[gingersmom]

If there's any way you can do it privately, then that's what I'd recommend. Just because you're entitled to services at the public schoold doesn't mean it's a good idea.

 

:iagree:

 

I would take out a second mortgage to afford speech therapy before I did it through the public school.

[angela in ohio]

I would go the private route, but not because I think your speech therapy will influence legislation. It's unlikely to make news. I would choose private simply becaue it will be better quality, and I don't mess around with therapy that will affect the rest of my child's life if there is any way I can afford the best.

[fhjmom]

I just researched this, because I need to have my 7yo evaluated. Are you registered as a private school in NJ? Here in Cali, there are no home schools, only very, very small private schools. Under IDEA, there are no specific provisions for home schools, but there are for private schools.

 

The local district is Federally mandated to evaluate every child. However, they are not obligated to treat every child (not within their district). Every district has to set aside a certain percentage of their IDEA funds to treat private schooled students. The amount is different for every district, based on an algorithm that plugs in a lot of district specific numbers. Once they have spent that money, they are not obligated to spend more. But once again, that's for private schools. There is no mandate for home schools.

 

Times are tight. Most districts are not going to be willing to spend more than they have to. If you want to pursue it, as for the evaluation again. Then see how pliable the administrators are.

 

In our case, even though I have a relationship with the top administrator (because my special needs son attends in the district), I'm still not sure that we're going to get anything more than an eval out of this. My goal is to get an idea of how serious the issue is and then make some decisions about how we will proceed.

 

Note: New Jersey may have its own laws in this matter, so check with your state home school association.

 

Also, another possible path would be through a homeschool charter. As has been said many times before, charters are public schools. When you enter a charter, you fall back under IDEA's mandatory treatment bracket.

:iagree: This sounds much like the situation in Texas, homeschools are considered very small, non-accredited private schools. Also, I agree that Childfind requires all schools to evaluate and indentify but there is not stipulation that every child not enrolled full time in the PS system be offered services.

 

As posted above, some of the federal monies do have to be spent serving the private school kids, but it is up to the local authorities to determine how those funds are distributed. It Texas it is up to each local district to decide and they must have a policy in place. For our district, younger students get priority and they provide any service they can, as appropriate outside a PS school classroom. I know other districts base in on types of service (i.e. they only offer speech therapy) or other criteria.

 

Also, before you fight a huge battle, I agree with those that say to find out if you believe it would be worth it. My older DD (7 YO) was dropped from speech services this year and I considered pushing to keep them, but the SLP that worked with her had no clue about kiddos with hearing loss and wasn't really helping her anyway, so even though I feel she could still benefit from speech & language therapy (heavy emphasis on the language, but they were only focusing on speech), I didn't feel what was offered through the school district was worth fighting for. We do still have services from the deaf ed teacher, though.

 

Also, something to think about - even if you do decide to push for services from the PS there is nothing to say you couldn't still also enroll in private therapy as well.

[Goldilocks]

We faced this question this year also. It was for my 4 yo and I did enroll him, but I was pushing for a type of therapy that they didn't want to provide. (I wanted the therapist to teach me HOW to teach him, so that I could work with him a little bit every day.) My husband didn't want me to push for it after they denied my request, so we are meeting about once a month with an excellent speech therapist who is teaching me how to teach my son.

[jenncslp]

I am personally a Speech-Language Pathologist, and though there are some public school therapists that do a good job, due to the logistics in the public schools, I would go the private route. Most public schools are overrun with therapy cases and the therapists simply have to squeeze them into groups. If you have 70+ kids on your caseload that you have to see once a week, you can't see them all alone. So many kiddos are placed in a group of 5 or 6 for a 1/2 hour at at time. Roughly the kids may get 4-5 minutes of individual attention. You also cannot usually be present, so there is little chance for carryover activities.

 

What I would do is look for a private therapist, experienced in the area you need. Double check with your insurance company to see if they cover any services, or if you can take it out of your FSA, if you have one.

 

I do therapy with a lot of homeschoolers. Some of them cannot afford weekly therapy, so I set them up with a plan of activities for the time that I cannot be there. They still have guidance and support, but can do much of the therapy on their own.

[Pippen]

Our district typically does a terrific job in the area of speech therapy for early childhood and elementary, however they are only required to do a minimal amount for students who are homeschooled or in private schools. They may choose to go beyond that threshold, but usually don't due to budget constraints.

 

One of the advantages to private therapy is that you may be able to find someone who will let you sit in on the therapy sessions so you can see what you can do at home to help.

[Shellydon]

When the IDEA (Individuals with Disabilities Education Act) law was revised a few years ago, there was a provision for 'parentally placed private school children' which includes homeschooled kids. Basically, if a parent chooses not to enroll their school aged child in public school they forfeit rights to access all the varies therapies. How a district chooses to handle this varies significantly. All of my local districts deny all therapy services to private and homeschooled children of kindergarten age and over. They do provide evaluations for free, but not therapy. This is completely legal under the current IDEA legislation.

[gardenmom5]

I'm currently in the process of this. technically, the school district is supposed to test students within 30 days if it is requested. that said, my experience with older child is: if they don't "know" there is anything wrong, they don't "have" to give services. Now I know there are advocates you can hire to go to bat with the school as well.

 

I just did a formal evaluation through our local medical center's development unit that crossed a host of fields. I received a diagosis and services suggested. because of who they are - the school HAS to accept their findings and support them. (we're currently also testing through the school as well, and the psychologist has seemed very supportive so far.) You can do a private work-up/eval, and the district MUST accept those findings and provide services.

 

I'm new at this = but also check out "wrights law". It should give information on how to appeal, and how to get the district ot provide the services they are legally obligated to provide.

 

ETA: the school district are required to also test homeschool kids - so far I've had no problem about homeschooling with the district - CHDD otoh: thinks he should be in school full time. total structure, lots of one on one and small groups. hello? what world do they live in?

Edited November 8, 2011 by gardenmom5

[melissel]

When the IDEA (Individuals with Disabilities Education Act) law was revised a few years ago, there was a provision for 'parentally placed private school children' which includes homeschooled kids. Basically, if a parent chooses not to enroll their school aged child in public school they forfeit rights to access all the varies therapies. How a district chooses to handle this varies significantly. All of my local districts deny all therapy services to private and homeschooled children of kindergarten age and over. They do provide evaluations for free, but not therapy. This is completely legal under the current IDEA legislation.

 

Oh, that's just lovely :glare: I thought I had read differently (and I was definitely told differently), but the mumbo jumbo was a bit confusing. Thanks for posting that for me.

 

Well, I went ahead and started the process with a private practice a few minutes from here. I know I'm lucky that my insurance does cover the sessions and that I'm in an area where there's an abundance of providers, so I decided to just forgo the whole potential mess. Hopefully this won't take long--DD is a budding singer, and she knows that her lisp will hold her back, so she's motivated to work on it. In the meantime, we'll take lots of videos before her sweet lisp is gone and consider it money well spent. She can support us with her vocal career in our old age :D

 

Thank you all for sharing your wisdom and advice. I appreciate it!

[Shellydon]

Oh, that's just lovely :glare: I thought I had read differently (and I was definitely told differently), but the mumbo jumbo was a bit confusing. Thanks for posting that for me.

 

Well, I went ahead and started the process with a private practice a few minutes from here. I know I'm lucky that my insurance does cover the sessions and that I'm in an area where there's an abundance of providers, so I decided to just forgo the whole potential mess. Hopefully this won't take long--DD is a budding singer, and she knows that her lisp will hold her back, so she's motivated to work on it. In the meantime, we'll take lots of videos before her sweet lisp is gone and consider it money well spent. She can support us with her vocal career in our old age :D

 

Thank you all for sharing your wisdom and advice. I appreciate it!

 

Your welcome! It stinks, but that is currently the way it works. If private schooling families wanted to lobby to change the legislation, they could do that.

[J-rap]

Our daughter has a hearing loss (wears hearing aids) and is monitored for her hearing, etc. through the public school system here. Her audiologist is a wonderful man, and we don't pay a penny to see him! As a result of her hearing loss, she has also met with a speech therapist through the public schools for about two years, twice/week, and again, we don't pay. (Of course I do realize that we pay through taxes.) The ST at the public school was very nice but seemed to be only an average therapist. My husband meets with a private speech therapist who is exceptional (for post-stroke language problems). If we decide to do the speech therapy route with our daughter again, it will probably be to see the private therapist. I don't know if that's typical for public vs. private?? I assume it's just in this particular situation.

I believe that our daughter was able to use the school services because every year in the fall, we have to submit a form to the district with our intention to homeschool. On the form, we have the option to opt out of absolutely everything, or to continue with any school services, counseling, or school testing AS WE SEE FIT. (Nothing is ever forced on us.) We've always opted for the second.

[melissel]

Your welcome! It stinks, but that is currently the way it works. If private schooling families wanted to lobby to change the legislation, they could do that.

 

I hear you. It seems a shame that we should have to though. We pay the same taxes everyone else does, and we're basically donating to the system. The bind is that lobbying for the right then opens us up to potential scrutiny and increased legislation, so we're ****ed if we do and ****ed if we don't. Our money is held hostage that way. Doesn't seem right :glare:

[fhjmom]

When the IDEA (Individuals with Disabilities Education Act) law was revised a few years ago, there was a provision for 'parentally placed private school children' which includes homeschooled kids. Basically, if a parent chooses not to enroll their school aged child in public school they forfeit rights to access all the varies therapies. How a district chooses to handle this varies significantly. All of my local districts deny all therapy services to private and homeschooled children of kindergarten age and over. They do provide evaluations for free, but not therapy. This is completely legal under the current IDEA legislation.

 

This is not the way I understand it. The school district is required by law to provide at least some services to some privately placed students, they are just not guaranteed for all students nor are the same services as would be available if enrolled full-time in the PS required.

 

The way it was explained to me is if the district has identified students who qualify for special education but have been placed in private school by parental choice, then the federal money received by the school district for those privately placed students must be spent on privately placed students. So if they get $1,000 per student from the federal coffers, and they have 10 private school students that have been identified as qualifying for special education, then the district must spend $10,000 on services for private school students. The issue is that they can set policy however they want on how that $10,000 is spent; not all 10 students have to be served and not all services have to be offered. They could spend all $10,000 on one student as long as the policy is followed equitably.

 

If a district is not offering any services to any privately placed students, then it is my understanding they are in violation of the law (assuming they have followed the mandate requiring them to evaluate and identify those students who qualify for special education and are receiving federal money for those students - if they aren't doing that, the issue of not offering services is part of a bigger problem).

 

Also, I am less clear on where homeschoolers fall in states where they are a separate category than private school students. Here they are one in the same, so the laws that apply to private school students include homeschoolers. I am not sure if homeschoolers have any access in those states where they are considered different.

[2squared]

You all just made me very thankful for our wonderful speech therapy provided by our public school system. My 7yo had a severe stutter, and he still goes for one-on-one therapy twice/week. When I called the school, they had him in for evaluation with a couple weeks, and his first appointment was within a month. This year the therapist scheduled us first before she scheduled the public schooled kids, so I got my choice of time slots. He has made fantastic progress, too.

 

Your experiences are just awful. :grouphug:

[MegP]

My son needs speech therapy, but we cannot afford it. The PS won't help us because we homeschool, and the University charges $90 per hour (and that is with a student!) They have a huge waiting list, also.

 

Homeschoolers are not private schoolers here in my state, so the school has no legal obligation to help homeschoolers.

 

It seems so unfair that homeschooled children cannot get the services they need without their parents going broke.

[Mandamom]

I have a public school kid, who was in Infants and Toddlers since 18 months, who after 3.5 years of public school speech, finally made amazing progress with a year's worth of private speech. He still has a moderate articulation disorder (lateral lisp and dyspraxia) and can be challenging to understand but it wasn't until the private therapist did her magic that the public school speech therapy started to become somewhat effective.

[Shellydon]

My son needs speech therapy, but we cannot afford it. The PS won't help us because we homeschool, and the University charges $90 per hour (and that is with a student!) They have a huge waiting list, also.

 

Homeschoolers are not private schoolers here in my state, so the school has no legal obligation to help homeschoolers.

 

It seems so unfair that homeschooled children cannot get the services they need without their parents going broke.

 

 

Hmmm.... Well, in many countries, children can't get speech therapy services at all. I wouldn't say it is unfair that speech therapy is offered as a free service in public school, but many choose not to use it.

[amy g.]

My son had private speech therapy for a lateral lisp beginning at age 3. At 5 he and my oldest started speech therapy at the local public school.

 

The therapy they received for free (tax dollars) was every bit as good as the therapy I had been paying for for 2 years. Their speech teacher even worked with my 3rd child for no pay because she needed the therapy, but it was not severe enough to qualify.

 

I know it depends on the school and the speech therapist, but I always feel the need to share the fact that I could not be more satisfied with how my children were respected, and the quality of speech therapy we received.

[mum]

Go private. The school therapists do not have the time to see a child for the length and frequency that is needed for effective treatment. I'm a therapist and am always frustrated by how little can be done in school. Not the school therapists fault at all, it's the system with too little money and too many needs.

[Embassy]

When I worked as a SLP in schools I usually saw homeschooled or preschool children individually before or after the regular school day. They had to be enrolled, but that was just paperwork so the school could get funding.

[kiwi3129]

Our experience (our dd has had speech therapy both through the public school system when she was enrolled there and through private therapy) is you get what you pay for. I realize you're paying property taxes for the school system, but there was a world of difference in the two therapies.

 

When she was in school she had speech 1/2 hour two times a week, but there were three other children in the session with her. Often these children had totally different issues than my daughter had. She made very slow, inconsistent progress (and that was over the course of four school years counting her years in a developmental preschool).

 

The private therapy was 1 hour a week, but she was the only one the therapist was working with. She made remarkable progress. Our insurance had agreed to pay for 13 weeks of therapy, but after the 13 weeks they said they should not have covered the therapy and would not pay for anymore sessions. I regret that we stopped her private therapy then.

 

Here we are three years later, and we're in the process of refinancing our house to get out money to pay for private speech and occupational therapy. It's ridiculously expensive, but in our experience it is worth it.

[Lecka]

My son is 6 and has articulation errors.

 

He is *not* easily stimulable with a lot of his errors. He never produced k or t on his own, in any position in the word.... it is supposed to be something easy but it took him a lot of hard work. He worked on that with EI -- he was in a group with 2 other kids. I always observed. The therapist used the kids to motivate each other and did get them to say a lot of words in their time.

 

Anyway he fell below the 10th percentile and could be accepted to private speech at the university clinic. It is $75/hour but my husband's insurance pays it all while he is below the 10th percentile. The school speech therapist helped me to arrange it for him, after he did not make hoped-for progress in K.

 

He did do better with one-on-one.

 

At this clinic I can watch him from an observation room -- they record the sessions and I watch on a tv with headphones.

 

They asked me not to work with him at home as he was not stimulable enough, so I was re-inforcing errors. I have never heard of another parent being told that. I still model correct pronunciation by repeating what he has said in some low-key way but that is all now.

 

Private has been wonderful for my son, but in our district I think he is unusual in not making progress with the school speech. The therapist always has 2+ university students doing student teaching with her, so even though it is a group the kids get individual attention, and I think the therapy is well-organized for the small groups.

 

edit: The university clinic in my town only takes the lowest-scoring kids, and tries to exit kids as fast as possible. That is just how it is. It ended up being no problem for him -- but the school therapist told me to over-mention any social problems, self-esteem problem, communication problems, or academic problems I thought he was having. I could truly mention some on the application -- but truly I don't like to focus on the negative. It is something to think about if you are going to a clinic instead of just a private provider.

Edited January 1, 2012 by Lecka