Kentucky Medicaid Funding Forms
Required Funding Forms
These forms are required by your state’s Medicaid program in addition to the standard funding forms listed below. Please make sure to download all forms as a PDF and fill in the forms electronically. Save as needed before submitting to Forbes AAC.
This is a required form for Kentucky Medicaid to be signed by physician.
Standard Funding Forms
The forms listed below must be received to complete your funding packet request. Once we have received all of the listed items, a funding expert will review your documentation to determine if any alterations are required prior to submission. We encourage all of our customers to reach out to us with any questions that you may have! NOTE: Spanish forms are available for the Client Information Form, the Feature Unlock Key and the Release of Information (ROI) and Assignment of Benefits Form (AOB).
A 4- to 6-week trial is required prior to purchase and must be documented in the evaluation.
An OT/PT report must be included with the Speech Language AAC Evaluation.
Contact your local funding specialist
Forbes AAC has a fully staffed funding team ready to assist you. We dedicate associates to specific geographic regions so that you can contact a local expert throughout the funding process.
By dedicating our experts on a regional basis, we provide you with a trusted partner to maximize our clients' likelihood for obtaining funding.