Not usually. All new clients begin with a free consultation so we can discuss the communication concern, what you are hoping for, and whether Forget-Me-Not appears to be a good fit.

If ongoing treatment is appropriate, you can usually begin without first completing a separate formal evaluation. A formal evaluation remains available when you or your caregiver would like one or when more comprehensive assessment is needed to answer a specific question.

People who seek services through a private practice often already have a meaningful understanding of the communication concern affecting them or their loved one. They may also have years of relevant history documented through medical records, school services, previous evaluations, developmental information, or other professional supports.

A new formal evaluation can require significant time, energy, and financial resources. It may also delay the start of treatment while assessment, scoring, interpretation, and report writing are completed.

Formal evaluations are valuable when their findings will help answer an important question, guide a decision, or provide documentation that will be used. However, I do not believe every client should be required to complete a comprehensive evaluation simply because it is the traditional or expected first step—particularly when the report is unlikely to be needed or used outside of treatment.

When appropriate, beginning with treatment allows us to use those resources to start addressing the client’s priorities sooner.

The first two treatment sessions include education, focused clinical assessment, information-gathering, and collaborative planning.

We may begin by building a shared understanding of the communication difference, including what is currently known, how it can vary from person to person, and how common myths or misconceptions may have shaped previous experiences or expectations. The goal is to understand the communication difference accurately and without judgment—not simply to identify what appears “wrong.”

Depending on your needs, this process may also include:

• discussion of your communication history and current experiences;

• review of previous evaluations, IEPs, medical records, or other supports;

• clinical observation and informal assessment activities;

• exploration of communication strengths, challenges, patterns, and environments;

• discussion of previous strategies and whether they were helpful;

• initial education, strategies, or treatment activities; and

• collaborative development of goals and a plan of care.

Clinical judgment is used throughout this process. By the end of the second session, we will use what we have learned to develop an individualized plan of care focused on the areas of life that you or your caregiver would most like to make easier, more accessible, or more aligned with your priorities.

A formal evaluation generally asks questions such as:

• What communication differences are present? What is the diagnosis?

• What factors may be contributing to them?

• What are the person’s communication strengths and support needs?

• What diagnoses, recommendations, or documentation may be appropriate?

• Is treatment medically necessary? What are the effects of not receiving services?

It may involve broader assessment across multiple communication areas, formal or informal testing, extensive record review, clinical interpretation, and a written report.

The treatment-starting process at Forget-Me-Not is more focused. It asks:

• How is this communication difference affecting the person’s life?

• Which situations feel most important, difficult, or limiting?

• What about communication would the client or caregiver like to make easier?

• What supports, strategies, or changes may help?

The information gathered during the first two treatment sessions is documented and used to create an individualized plan of care, including treatment goals. However, it is intended primarily to guide services at Forget-Me-Not and does not include a comprehensive written evaluation report.

In many insurance-based settings, an evaluation is used to establish a diagnosis, demonstrate medical necessity, or determine whether someone meets specific eligibility requirements before treatment can be authorized.

Forget-Me-Not is a private-pay practice. Clients do not need to meet an insurance company’s eligibility criteria before receiving support.

My approach recognizes that when a person or caregiver seeks services, a communication difference is often already affecting some part of daily life. The free consultation allows me to determine whether the concern falls within my scope, whether treatment appears appropriate, and whether we are a good match.

From there, we can decide together whether the most useful next step is treatment, a focused Communication Support Session, or a formal evaluation.

A formal evaluation may be worthwhile when you or your caregiver would like:

• a more comprehensive understanding of communication strengths and needs;

• diagnostic clarification;

• assessment across multiple communication areas;

• a detailed written report;

• updated recommendations;

• documentation for a school, workplace, medical provider, agency, or another professional; or

• information that may affect a significant educational, medical, or support decision.

A formal evaluation may also be recommended if the concern is unclear, if several possible communication differences need to be explored, or if more information is necessary to determine the appropriate next step.

The scope, fee, and format will be discussed before scheduling so you can decide whether the evaluation is likely to be useful for your goals.

Whenever clinically appropriate, the decision ultimately belongs to the client or caregiver.

During the free consultation, I will explain the available options, what each pathway includes, and whether I believe a formal evaluation would provide meaningful additional information. You can then decide whether the time, cost, energy, and documentation involved align with what you need.

Choosing to begin treatment without a formal evaluation does not mean that assessment, clinical judgment, documentation, or goal-setting are skipped. It means that the process is focused on developing a practical plan for making the areas of life affected by the communication difference easier, more accessible, or more aligned with the client’s priorities.

You are welcome to share previous evaluations, IEPs, treatment records, school reports, medical records, or other relevant documentation.

I will review them to understand your history, previous findings, existing supports, and recommendations. These records may provide much of the background information that would otherwise need to be gathered and may help us begin treatment more efficiently.

You do not automatically need another formal evaluation simply because you are beginning services at Forget-Me-Not. After the free consultation and record review, we may decide to begin treatment, schedule a focused Communication Support Session, or complete a formal evaluation if there are additional questions you would like answered or documentation you need.