AAC Referral Form

Click the button below to access the online referral + consent form or referral + medical consent PDF template.

Please return via FAX (972) 647-0040 or referrals@metrocare.com

AAC REFERRAL FORM + medical consent - pdf template
AAC REFERRAL FORM + medical consent - online form
 

AAC Medical Consent Form

Click below to download a PDF version of our AAC Medical Consent Form

Please return via FAX (972) 647-0040 or referrals@metrocare.com

aac medical consent form
 

AAC Medical Release Form

Click below to link to the online AAC Medical Release Form

AAC Medical Release online form
 

AAC Evaluation Template

Click the button below to access either the online evaluation or PDF evaluation template

aac evaluation - online form

Please return via (972) 647-0040 or referrals@metrocare.com

AAC EVALUATION - pdf TEMPLATE

Please return via (972) 647-0040 or referrals@metrocare.com

 

AAC Texas Medicaid 90-Day Trial Device Form 

Click the button below to access either the below to access the online form

aac Texas Medicaid 90-day trial device form

Please return via (972) 647-0040 or referrals@metrocare.com

 

AAC In-Service Request Form

aac inservice request - online form