New Beginnings | NB1-Office

Patient Name: Julietta

Patient Information:

Patient ID: 9935

Patient First Name: Julietta

Patient Date of Birth: 07-18-2022

Gender: Female

Assigned Office: NB1 east side

Primary Care Physician: Riddhi, Patel

Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy: Lopez, Jazmin

FD - Feeding Therapy:

OT - Occupational Therapy:

PT - Physical Therapy:

Patient Primary Authorizations:

Auth. ID	Status	Start Date	End Date	Insurance	ST-Units	FD-Units	OT-Units	PT-Units
23466	Active	02-23-2026	08-21-2026	El Paso First Health Plans	52	0	0	0

Speech and Language Evaluation:

ID	Date	Type	Evaluation Diagnosis
26166	01-29-2026	Speech Initial Evaluation	F80.2
Speech Background History: Julietta was referred for a comprehensive speech and language evaluation due to concerns regarding delayed language development and reduced speech intelligibility. Mother served as the primary informant throughout the evaluation and provided relevant developmental and medical history. Julietta is exposed to both English and Spanish within the home environment; therefore, assessment was conducted in both languages to ensure an accurate representation of her communication abilities and to avoid misidentification of a language difference. Julietta primarily communicates through pointing, gestures, and limited verbal output. She currently uses approximately 15 words, including “mommy,” “papi,” “what,” “donde,” “please,” “hello,” “bye,” and “yummy.” Her communication is typically restricted to single word utterances, and she frequently relies on gestures such as “more” and “all done” to express her needs. Mother reports that much of Julietta’s speech is difficult to understand and often resembles gibberish, particularly for unfamiliar listeners. Medical history is unremarkable. Julietta passed her newborn hearing and vision screenings, experienced no complications during pregnancy or delivery, and is not currently taking any medications. Developmental milestones were reportedly achieved within expected timeframes with the exception of speech and language development. Julietta currently remains at home during the day and has not yet attended daycare or school. Mother reports that Julietta interacts well with other children, follows instructions appropriately, and appears to understand most spoken language; however, her expressive communication remains significantly limited. Mother’s primary concern is that Julieta uses very few words and is not yet producing phrases or sentences expected for her age.
Speech Medical History: Per parent report, medical history is not remarkable
Speech Medications: None at this time
Speech Behavioral Observations: Attending Skills: Adequate, Response Rate: Appropriate, Level of Activity: WNL, Cooperation: WNL, Communicative Intent: Adequate, Awareness of Others: Present, Reliability of Scores: Adequate, Awarencess of Environmental Events: Good, Social Interactions: Usually, Prognosis for Improved Communicative Functioning: WNL,
Speech Communication Strengths: Appropriate use of eye contact, Auditory and visually alert and attentive, Interactive, Responds to greetings,
Speech Communication Weaknesses: Difficult to understand, Diminished vocabulary, Poor vocabulary, Unable to answer questions, Unable to participate in a conversation, Unintelligible,
Speech Background Summary:
Speech Diagnosis/Impressions: Julietta was referred for a comprehensive speech and language evaluation due to concerns regarding delayed language development and reduced speech intelligibility. Mother served as the primary informant throughout the evaluation and provided relevant developmental and medical history. Julietta is exposed to both English and Spanish within the home environment; therefore, assessment was conducted in both languages to ensure an accurate representation of her communication abilities and to avoid misidentification of a language difference. Julietta primarily communicates through pointing, gestures, and limited verbal output. She currently uses approximately 15 words, including “mommy,” “papi,” “what,” “donde,” “please,” “hello,” “bye,” and “yummy.” Her communication is typically restricted to single word utterances, and she frequently relies on gestures such as “more” and “all done” to express her needs. Mother reports that much of Julietta’s speech is difficult to understand and often resembles gibberish, particularly for unfamiliar listeners. Medical history is unremarkable. Julietta passed her newborn hearing and vision screenings, experienced no complications during pregnancy or delivery, and is not currently taking any medications. Developmental milestones were reportedly achieved within expected timeframes with the exception of speech and language development. Julietta currently remains at home during the day and has not yet attended daycare or school. Mother reports that Julietta interacts well with other children, follows instructions appropriately, and appears to understand most spoken language; however, her expressive communication remains significantly limited. Mother’s primary concern is that Julieta uses very few words and is not yet producing phrases or sentences expected for her age. Throughout the evaluation, Juliette presented as pleasant, cooperative, and eager to engage with the clinician. She demonstrated appropriate participation during both structured and play based activities. Functional, relational, and self directed play skills were observed, suggesting emerging cognitive and social abilities that support readiness for intervention. The Preschool Language Scales Fifth Edition (PLS 5) was administered in both English and Spanish. On the Auditory Comprehension subtest, Juliette obtained a raw score of 16, a standard score of 50, a percentile rank of 1, and an age equivalent of approximately 1 year. On the Expressive Communication subtest, she earned a raw score of 22, a standard score of 61, a percentile rank of 1, and an age equivalent of 1 year and 7 months. Juliette received a Total Language standard score of 52 with a percentile rank of 1 and an age equivalent of approximately 1 year and 3 months. These results indicate a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER, with language abilities falling significantly below developmental expectations. Despite bilingual exposure, delays were present across both languages, supporting the presence of a true language disorder rather than a language difference. At 3 years and 6 months of age, children are typically expected to speak in 3 to 5 word sentences, use a vocabulary exceeding 1,000 words ,be understood by unfamiliar listeners approximately 75 to 90 percent of the time , follow multi step directions, ask and answer simple questions, use language for a variety of pragmatic functions such as requesting, commenting, protesting, and engaging socially, demonstrate conversational turn taking, and use grammatical markers including plurals, verb tense, and pronouns Juliette currently demonstrates communication skills more consistent with a child between 12 and 19 months of age, representing a severe developmental gap of over two years. This degree of delay places her at significant risk for ongoing communication impairment without immediate intervention. Juliette demonstrated several strengths during the evaluation. She engaged in functional and relational play, maintained appropriate eye contact during simple games, used symbolic gestures, vocalized and babbled two syllables, produced at least one true word, and participated in reciprocal vocal turn taking. These skills are positive indicators for future progress with early intervention. However, notable areas of need were observed. Receptively, Juliette demonstrated difficulty looking toward objects or people when pointed to, following familiar directions even when paired with gestures, identifying familiar objects, identifying photographs of common items, and understanding commands supported by gestural cues. Expressively, she exhibited difficulty initiating turn taking interactions, using words for a variety of pragmatic functions, relying on words rather than gestures to communicate, combining words into phrases, expanding consonant combinations, and producing intelligible speech. Juliette’s communication deficits significantly limit her ability to express basic wants and needs, repair communication breakdowns, be understood by caregivers and peers, engage in age appropriate conversation, and participate in structured learning environments. When a child of this age cannot communicate effectively, frustration often increases while opportunities for social and academic learning decrease. Without intervention, children demonstrating delays of this magnitude are at substantially increased risk for future academic challenges, literacy difficulties, social impairment, and persistent language disorder. Speech therapy is medically necessary for Juliette due to a severe developmental language disorder that negatively impacts her functional communication across daily environments. Skilled intervention from a licensed Speech Language Pathologist is required to develop foundational receptive and expressive language skills, improve speech intelligibility, reduce communication related frustration, support social development, and prevent widening developmental gaps. Caregiver strategies alone are not sufficient to remediate a disorder of this magnitude. Early intervention is critical and delaying treatment may result in long term language impairment and a greater need for intensive services later. Skilled speech therapy is necessary to provide structured, evidence based treatment targeting language acquisition, intelligibility, and functional communication. Given Juliette’s bilingual environment, therapy will be provided in both English and Spanish to promote skill generalization across settings and communication partners. Prognosis is considered good due to Juliette’s engagement, emerging play skills, social interest, and strong caregiver support, provided intervention begins promptly and services are delivered consistently. Juliette presents with a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER that significantly impacts her ability to communicate effectively. Immediate speech therapy is strongly recommended, as services are medically necessary to support her developmental progress, safety, social participation, and future academic success.
Speech Diagnosis/Impressions: Julietta was referred for a comprehensive speech and language evaluation due to concerns regarding delayed language development and reduced speech intelligibility. Mother served as the primary informant throughout the evaluation and provided relevant developmental and medical history. Julietta is exposed to both English and Spanish within the home environment; therefore, assessment was conducted in both languages to ensure an accurate representation of her communication abilities and to avoid misidentification of a language difference. Julietta primarily communicates through pointing, gestures, and limited verbal output. She currently uses approximately 15 words, including “mommy,” “papi,” “what,” “donde,” “please,” “hello,” “bye,” and “yummy.” Her communication is typically restricted to single word utterances, and she frequently relies on gestures such as “more” and “all done” to express her needs. Mother reports that much of Julietta’s speech is difficult to understand and often resembles gibberish, particularly for unfamiliar listeners. Medical history is unremarkable. Julietta passed her newborn hearing and vision screenings, experienced no complications during pregnancy or delivery, and is not currently taking any medications. Developmental milestones were reportedly achieved within expected timeframes with the exception of speech and language development. Julietta currently remains at home during the day and has not yet attended daycare or school. Mother reports that Julietta interacts well with other children, follows instructions appropriately, and appears to understand most spoken language; however, her expressive communication remains significantly limited. Mother’s primary concern is that Julieta uses very few words and is not yet producing phrases or sentences expected for her age. Throughout the evaluation, Juliette presented as pleasant, cooperative, and eager to engage with the clinician. She demonstrated appropriate participation during both structured and play based activities. Functional, relational, and self directed play skills were observed, suggesting emerging cognitive and social abilities that support readiness for intervention. The Preschool Language Scales Fifth Edition (PLS 5) was administered in both English and Spanish. On the Auditory Comprehension subtest, Juliette obtained a raw score of 16, a standard score of 50, a percentile rank of 1, and an age equivalent of approximately 1 year. On the Expressive Communication subtest, she earned a raw score of 22, a standard score of 61, a percentile rank of 1, and an age equivalent of 1 year and 7 months. Juliette received a Total Language standard score of 52 with a percentile rank of 1 and an age equivalent of approximately 1 year and 3 months. These results indicate a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER, with language abilities falling significantly below developmental expectations. Despite bilingual exposure, delays were present across both languages, supporting the presence of a true language disorder rather than a language difference. At 3 years and 6 months of age, children are typically expected to speak in 3 to 5 word sentences, use a vocabulary exceeding 1,000 words ,be understood by unfamiliar listeners approximately 75 to 90 percent of the time , follow multi step directions, ask and answer simple questions, use language for a variety of pragmatic functions such as requesting, commenting, protesting, and engaging socially, demonstrate conversational turn taking, and use grammatical markers including plurals, verb tense, and pronouns Juliette currently demonstrates communication skills more consistent with a child between 12 and 19 months of age, representing a severe developmental gap of over two years. This degree of delay places her at significant risk for ongoing communication impairment without immediate intervention. Juliette demonstrated several strengths during the evaluation. She engaged in functional and relational play, maintained appropriate eye contact during simple games, used symbolic gestures, vocalized and babbled two syllables, produced at least one true word, and participated in reciprocal vocal turn taking. These skills are positive indicators for future progress with early intervention. However, notable areas of need were observed. Receptively, Juliette demonstrated difficulty looking toward objects or people when pointed to, following familiar directions even when paired with gestures, identifying familiar objects, identifying photographs of common items, and understanding commands supported by gestural cues. Expressively, she exhibited difficulty initiating turn taking interactions, using words for a variety of pragmatic functions, relying on words rather than gestures to communicate, combining words into phrases, expanding consonant combinations, and producing intelligible speech. Juliette’s communication deficits significantly limit her ability to express basic wants and needs, repair communication breakdowns, be understood by caregivers and peers, engage in age appropriate conversation, and participate in structured learning environments. When a child of this age cannot communicate effectively, frustration often increases while opportunities for social and academic learning decrease. Without intervention, children demonstrating delays of this magnitude are at substantially increased risk for future academic challenges, literacy difficulties, social impairment, and persistent language disorder. Speech therapy is medically necessary for Juliette due to a severe developmental language disorder that negatively impacts her functional communication across daily environments. Skilled intervention from a licensed Speech Language Pathologist is required to develop foundational receptive and expressive language skills, improve speech intelligibility, reduce communication related frustration, support social development, and prevent widening developmental gaps. Caregiver strategies alone are not sufficient to remediate a disorder of this magnitude. Early intervention is critical and delaying treatment may result in long term language impairment and a greater need for intensive services later. Skilled speech therapy is necessary to provide structured, evidence based treatment targeting language acquisition, intelligibility, and functional communication. Given Juliette’s bilingual environment, therapy will be provided in both English and Spanish to promote skill generalization across settings and communication partners. Prognosis is considered good due to Juliette’s engagement, emerging play skills, social interest, and strong caregiver support, provided intervention begins promptly and services are delivered consistently. Juliette presents with a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER that significantly impacts her ability to communicate effectively. Immediate speech therapy is strongly recommended, as services are medically necessary to support her developmental progress, safety, social participation, and future academic success.
Speech Recommendations: Speech Therapy: 2 time(s) a Week for 30 to 45 minute sessions

Speech and Language Plan of Care:

Plan of Care

58258

Plan Date: 01-29-2026

Speech Assessment Summary: Julietta was referred for a comprehensive speech and language evaluation due to concerns regarding delayed language development and reduced speech intelligibility. Mother served as the primary informant throughout the evaluation and provided relevant developmental and medical history. Julietta is exposed to both English and Spanish within the home environment; therefore, assessment was conducted in both languages to ensure an accurate representation of her communication abilities and to avoid misidentification of a language difference. Julietta primarily communicates through pointing, gestures, and limited verbal output. She currently uses approximately 15 words, including “mommy,” “papi,” “what,” “donde,” “please,” “hello,” “bye,” and “yummy.” Her communication is typically restricted to single word utterances, and she frequently relies on gestures such as “more” and “all done” to express her needs. Mother reports that much of Julietta’s speech is difficult to understand and often resembles gibberish, particularly for unfamiliar listeners. Medical history is unremarkable. Julietta passed her newborn hearing and vision screenings, experienced no complications during pregnancy or delivery, and is not currently taking any medications. Developmental milestones were reportedly achieved within expected timeframes with the exception of speech and language development. Julietta currently remains at home during the day and has not yet attended daycare or school. Mother reports that Julietta interacts well with other children, follows instructions appropriately, and appears to understand most spoken language; however, her expressive communication remains significantly limited. Mother’s primary concern is that Julieta uses very few words and is not yet producing phrases or sentences expected for her age. Throughout the evaluation, Juliette presented as pleasant, cooperative, and eager to engage with the clinician. She demonstrated appropriate participation during both structured and play based activities. Functional, relational, and self directed play skills were observed, suggesting emerging cognitive and social abilities that support readiness for intervention. The Preschool Language Scales Fifth Edition (PLS 5) was administered in both English and Spanish. On the Auditory Comprehension subtest, Juliette obtained a raw score of 16, a standard score of 50, a percentile rank of 1, and an age equivalent of approximately 1 year. On the Expressive Communication subtest, she earned a raw score of 22, a standard score of 61, a percentile rank of 1, and an age equivalent of 1 year and 7 months. Juliette received a Total Language standard score of 52 with a percentile rank of 1 and an age equivalent of approximately 1 year and 3 months. These results indicate a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER, with language abilities falling significantly below developmental expectations. Despite bilingual exposure, delays were present across both languages, supporting the presence of a true language disorder rather than a language difference. At 3 years and 6 months of age, children are typically expected to speak in 3 to 5 word sentences, use a vocabulary exceeding 1,000 words ,be understood by unfamiliar listeners approximately 75 to 90 percent of the time , follow multi step directions, ask and answer simple questions, use language for a variety of pragmatic functions such as requesting, commenting, protesting, and engaging socially, demonstrate conversational turn taking, and use grammatical markers including plurals, verb tense, and pronouns Juliette currently demonstrates communication skills more consistent with a child between 12 and 19 months of age, representing a severe developmental gap of over two years. This degree of delay places her at significant risk for ongoing communication impairment without immediate intervention. Juliette demonstrated several strengths during the evaluation. She engaged in functional and relational play, maintained appropriate eye contact during simple games, used symbolic gestures, vocalized and babbled two syllables, produced at least one true word, and participated in reciprocal vocal turn taking. These skills are positive indicators for future progress with early intervention. However, notable areas of need were observed. Receptively, Juliette demonstrated difficulty looking toward objects or people when pointed to, following familiar directions even when paired with gestures, identifying familiar objects, identifying photographs of common items, and understanding commands supported by gestural cues. Expressively, she exhibited difficulty initiating turn taking interactions, using words for a variety of pragmatic functions, relying on words rather than gestures to communicate, combining words into phrases, expanding consonant combinations, and producing intelligible speech. Juliette’s communication deficits significantly limit her ability to express basic wants and needs, repair communication breakdowns, be understood by caregivers and peers, engage in age appropriate conversation, and participate in structured learning environments. When a child of this age cannot communicate effectively, frustration often increases while opportunities for social and academic learning decrease. Without intervention, children demonstrating delays of this magnitude are at substantially increased risk for future academic challenges, literacy difficulties, social impairment, and persistent language disorder. Speech therapy is medically necessary for Juliette due to a severe developmental language disorder that negatively impacts her functional communication across daily environments. Skilled intervention from a licensed Speech Language Pathologist is required to develop foundational receptive and expressive language skills, improve speech intelligibility, reduce communication related frustration, support social development, and prevent widening developmental gaps. Caregiver strategies alone are not sufficient to remediate a disorder of this magnitude. Early intervention is critical and delaying treatment may result in long term language impairment and a greater need for intensive services later. Skilled speech therapy is necessary to provide structured, evidence based treatment targeting language acquisition, intelligibility, and functional communication. Given Juliette’s bilingual environment, therapy will be provided in both English and Spanish to promote skill generalization across settings and communication partners. Prognosis is considered good due to Juliette’s engagement, emerging play skills, social interest, and strong caregiver support, provided intervention begins promptly and services are delivered consistently. Juliette presents with a PROFOUND MIXED RECEPTIVE EXPRESSIVE LANGUAGE DISORDER that significantly impacts her ability to communicate effectively. Immediate speech therapy is strongly recommended, as services are medically necessary to support her developmental progress, safety, social participation, and future academic success.

Speech Progress to Date: N/A

Speech Rehabilitation Potential: Good. with consistent Speech Therapy and parental support. Prognosis for improvement in the area of her impairments is good with continued, consistent speech therapy. Julietta will be discharged when she achieves a standard score above 1.5 standard deviations from the mean for all impairments, indicating that her speech and language skills will be in the mild to average range and she will have met all long term therapy goals.

Speech and Language Long Term Goals:

Category	Goal Description
Home Management Intervention Program	When counseled by the clinician, parents will incorporate the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home.
Receptive Language	Within 1 year, Julietta will utilize age appropriate receptive language skills in order to communicate effectively with family and peers with 60% accuracy.
Expressive Language	Within 1 year, Julietta will utilize age appropriate expressive language skills in order to communicate effectively with family and peers with 60% accuracy.

Speech and Language Short Term Goals:

Category	Goal Description
Receptive Language	Within 6 months, Julietta will identify common objects during play based tasks with decreasing multisensory cues with 30% accuracy in order to promote independence so that Julietta can increase her receptive vocabulary and eventually her expressive vocabulary.
Receptive Language	Within 6 months, Julietta will follow 1-2 step commands involving spatial concepts with 30% accuracy, in order to increase understanding and improve functional communication with family, caregivers, and peers
Expressive Language	Within 6 months time, Julietta will use functional verbal words and verbal approximations to communicate wants and needs (e.g., “more,” “open,” “help,” “go”) in 30% of opportunities across 3 consecutive sessions with fading prompts, to increase her spontaneous expressive language in daily routines
Expressive Language	Within 6 months, Julietta will name familiar objects in pictures with 30% accuracy in order to promote independence and safety so that Julietta will increase her expressive vocabulary.
Expressive Language	Within 6 months, Juliette will combine two words to form functional phrases (such as “more juice” or “mommy help”) in 30% of opportunities in order to promote independence and safety so that Julietta will increase her expressive vocabulary.

Speech and Language Soap Note/Visit:

Soap Note

491046

Note Date: 03-23-2026

Subjective: Patient was friendly and cooperative,

Assessment of Goals/Response to Treatment: When counseled by the clinician, parents will incorporate the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home. Julietta identified common objects during play based tasks with decreasing multisensory cues with 20% accuracy with max verbal cues. Julietta followed 1-2 step commands involving spatial concepts with 10% accuracy with max verbal and visual cues. Julietta used functional verbal words and verbal approximations to communicate wants and needs (e.g., “more,” “open,” “help,” “go”) with 10% accuracy with max verbal cues. Julietta named familiar objects in pictures with 10% accuracy with max verbal cues. Juliette combined two words to form functional phrases (such as “more juice” or “mommy help”) in 20% of opportunities with max verbal and visual cues.

Plans: Continue with current Plan of Care,

Additional Notes:

Completed Appointments:

ID	Plan of Care

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
878547	92523: Artic & Language Eval	01-29-2026 04:00 PM	01-29-2026 04:45 PM	Lailani Chehedeh	NB1 east side	Completed
901070	92507: Speech & Language Visit	03-03-2026 10:30 AM	03-03-2026 11:00 AM	Jazmin Lopez	NB1 east side	Completed
901071	92507: Speech & Language Visit	03-10-2026 10:30 AM	03-10-2026 11:00 AM	Jazmin Lopez	NB1 east side	Completed
901035	92507: Speech & Language Visit	03-12-2026 10:00 AM	03-12-2026 10:30 AM	Jazmin Lopez	NB1 east side	Completed

Canceled Appointments:

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
901034	92507: Speech & Language Visit	03-05-2026 10:00 AM	03-05-2026 10:30 AM	Jazmin Lopez	NB1 east side	Canceled
901072	92507: Speech & Language Visit	03-17-2026 10:30 AM	03-17-2026 11:00 AM	Jazmin Lopez	NB1 east side	Canceled
901036	92507: Speech & Language Visit	03-19-2026 10:00 AM	03-19-2026 10:30 AM	Jazmin Lopez	NB1 east side	Canceled

Scheduled Appointments:

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
901074	92507: Speech & Language Visit	03-31-2026 10:30 AM	03-31-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901038	92507: Speech & Language Visit	04-02-2026 10:00 AM	04-02-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901075	92507: Speech & Language Visit	04-07-2026 10:30 AM	04-07-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901039	92507: Speech & Language Visit	04-09-2026 10:00 AM	04-09-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901076	92507: Speech & Language Visit	04-14-2026 10:30 AM	04-14-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901040	92507: Speech & Language Visit	04-16-2026 10:00 AM	04-16-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901077	92507: Speech & Language Visit	04-21-2026 10:30 AM	04-21-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901041	92507: Speech & Language Visit	04-23-2026 10:00 AM	04-23-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901078	92507: Speech & Language Visit	04-28-2026 10:30 AM	04-28-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901042	92507: Speech & Language Visit	04-30-2026 10:00 AM	04-30-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901079	92507: Speech & Language Visit	05-05-2026 10:30 AM	05-05-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901043	92507: Speech & Language Visit	05-07-2026 10:00 AM	05-07-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901080	92507: Speech & Language Visit	05-12-2026 10:30 AM	05-12-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901044	92507: Speech & Language Visit	05-14-2026 10:00 AM	05-14-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901081	92507: Speech & Language Visit	05-19-2026 10:30 AM	05-19-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901045	92507: Speech & Language Visit	05-21-2026 10:00 AM	05-21-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901082	92507: Speech & Language Visit	05-26-2026 10:30 AM	05-26-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901046	92507: Speech & Language Visit	05-28-2026 10:00 AM	05-28-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901083	92507: Speech & Language Visit	06-02-2026 10:30 AM	06-02-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901047	92507: Speech & Language Visit	06-04-2026 10:00 AM	06-04-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901084	92507: Speech & Language Visit	06-09-2026 10:30 AM	06-09-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901048	92507: Speech & Language Visit	06-11-2026 10:00 AM	06-11-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901085	92507: Speech & Language Visit	06-16-2026 10:30 AM	06-16-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901049	92507: Speech & Language Visit	06-18-2026 10:00 AM	06-18-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901086	92507: Speech & Language Visit	06-23-2026 10:30 AM	06-23-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901050	92507: Speech & Language Visit	06-25-2026 10:00 AM	06-25-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901087	92507: Speech & Language Visit	06-30-2026 10:30 AM	06-30-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901051	92507: Speech & Language Visit	07-02-2026 10:00 AM	07-02-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901088	92507: Speech & Language Visit	07-07-2026 10:30 AM	07-07-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901052	92507: Speech & Language Visit	07-09-2026 10:00 AM	07-09-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901089	92507: Speech & Language Visit	07-14-2026 10:30 AM	07-14-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901053	92507: Speech & Language Visit	07-16-2026 10:00 AM	07-16-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901090	92507: Speech & Language Visit	07-21-2026 10:30 AM	07-21-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901054	92507: Speech & Language Visit	07-23-2026 10:00 AM	07-23-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901091	92507: Speech & Language Visit	07-28-2026 10:30 AM	07-28-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901055	92507: Speech & Language Visit	07-30-2026 10:00 AM	07-30-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901092	92507: Speech & Language Visit	08-04-2026 10:30 AM	08-04-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901056	92507: Speech & Language Visit	08-06-2026 10:00 AM	08-06-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901093	92507: Speech & Language Visit	08-11-2026 10:30 AM	08-11-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled
901057	92507: Speech & Language Visit	08-13-2026 10:00 AM	08-13-2026 10:30 AM	Jazmin Lopez	NB1 east side	Scheduled
901094	92507: Speech & Language Visit	08-18-2026 10:30 AM	08-18-2026 11:00 AM	Jazmin Lopez	NB1 east side	Scheduled

Paient Notes:

Date	Posted By	Description
03-17-2026	Jazmin Lopez	Mother reported that Julietta is currently hospitalized due to low oxygen levels. She shared that Julietta became very ill and required hospital admission. At this time, mother is unsure how long they will be in the hospital
02-26-2026	Shekinah Velasquez	ST auth approved starting 02/23/2026 - 08/21/2026 2x/ week = 52 visits. Therapist assigned and notified.
02-19-2026	Shekinah Velasquez	Addendum Request faxed to EPH to change providers name. Pending response.
02-18-2026	Avery Fontenot	ST Auth submitted to EPH. Pending approval.
02-11-2026	Avery Fontenot	Called office and they stated that they did receive paperwork they are just pending signatures from doctor.
02-06-2026	Avery Fontenot	St paperwork and request for THSTEPS to PCP.

Paient Missed Visit Notes:

Date	Service	Therapist	Description
03-19-2026	92507	Lopez, Jazmin
03-17-2026	92507	Lopez, Jazmin
03-05-2026	92507	Lopez, Jazmin

Paient Messages Admin:

Date	Posted By	Message
01-21-2026 03:05 PM	Avery Fontenot	Please fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2560
01-21-2026 03:27 PM	Shekinah Velasquez	Julietta has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9935&type=1&wid=513
02-03-2026 03:51 PM	Caleb Tullius	🌟 You’re Invited! 🌟 Join us as we celebrate the unveiling of the Sensory Nook we proudly donated to the library! Come see the space, explore, and enjoy this special moment with us. 📅 February 7th, 2026 ⏰ 4:30 PM 📍 Esperanza Acosta Moreno Public Library We’d love to see you there! 💙 🌟 ¡Están invitados! 🌟 Acompáñenos a celebrar la inauguración del Rincón Sensorial que con orgullo donamos a la biblioteca. Vengan a conocer el espacio y compartir este momento especial con nosotros. 📅 7 de febrero de 2026 ⏰ 4:30 p.m. 📍 Biblioteca Pública Esperanza Acosta Moreno ¡Esperamos verlos! 💙
02-16-2026 05:27 PM	Caleb Tullius	Join us this Wednesday!
02-16-2026 05:48 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Introduction to AAC (Augmentative and Alternative Communication). This session introduces AAC in a simple, supportive way on why it's used and how it helps children communicate. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=19&pid=9935
02-18-2026 04:15 PM	Stephen Tullius	For those of you that would like to attend our parent training: Introduction to AAC, but are not able to attend in person, we are setting up a webinar. This will be our first attempt at a webinar so I hope it goes well :) Here is the link: https://webinar.getresponse.com/JvvC9/introduction-to-aac/
02-26-2026 01:45 PM	Shekinah Velasquez	Hi, Julietta as been assigned a therapist for Speech and Language therapy. Here's a link to learn more about Jazmin https://st-pros.com/newbeginnings/reports/welcomefromtherapist.aspx?id=9935&tid=35
03-09-2026 07:22 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Sensory Play. In this session learn how to create safe, engaging sensory experiences that help hypersensitive children regulate their responses to touch, sound, and movement. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=20&pid=9935
03-11-2026 05:40 PM	Stephen Tullius	Hello, for anybody who would like to attend our Sensory Play parent training today but can't, we will be attempting a webinar version. You can register to see it online at https://webinar.getresponse.com/JvvC9/sensory-play/

Paient Messages Therapist:

Date	Posted By	Message
01-24-2026 12:56 PM	Lailani Chehedeh	Hi Mrs.Garcia, My name is Lailani and I'm a speech language pathologist from New Beginnings. I will be conducting Julietta's speech and language evaluation. :) Before our in person appointment, I just need to gather some background information. So when you have an opportunity can you answer these questions for me: 1.) Any complications with pregnancy or birth? 2.) major illnesses or accident since last check up? Any medical diagnoses (i.e., Autism, ADHD, down syndrome, etc.)? 3.) developmental milestones met within normal limits? or delayed? 4.) sleeping or breathing issues? does patient get 8-10 hrs sleep? wake up several times a night? snoring? sleep with mouth open or closed? enlarged tonsils? 5.) medications? 6.) education? (i.e., day care, preschool) 7.) vision or hearing issues? 8.) In your a few words write your parental concerns with SPEECH and LANGUAGE along with your child’s strengths. 9.) when did your concerns begin? 10) Any history of previous therapy (i.e., speech, occupational therapy, physical therapy, counseling, etc.) 11) Dominate Language ? English or Spanish ?
01-25-2026 11:36 AM	Julietta Garcia	Julietta (Prim) Replied: Hello ma'am, I hope I answered your questions correctly and looking forward to start with you soon 1. No complications during birth 2. No 3. Has met every developmental milestone, except for delayed speech... 4. Has low oxygen when sick, but not diagnosed with asthma/ Sleeps well 5. None 6. Stays at home with me, no school yet 7. No 8. She can say a few words but does not say full sentences yet, she understands almost everything I say, can interact with other children fine, and does good with instructions 9. Recently just noticed she's behind in her speech and wanted her to get extra help just to help her get where she needs to be 10. No 11. Both
01-25-2026 11:36 AM	Lailani Chehedeh	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-28-2026 08:58 AM	Lailani Chehedeh	Thank you so much for answering these questions ! We are scheduled for tomorrow @4:45pm. 1512 N Zaragoza C-1 is the location :)
01-28-2026 06:30 PM	Lailani Chehedeh	Hi, this is a just a reminder that Julietta has a Speech Evaluation appointment scheduled tomorrow at 04:45 PM. See you soon! - New Beginnings 🙂
01-29-2026 07:56 AM	Lailani Chehedeh	Hi, this is a just a reminder that Julietta has a Speech Evaluation appointment scheduled today at 04:45 PM. See you soon! - New Beginnings 🙂
01-29-2026 08:18 AM	Julietta Garcia	Julietta (Prim) Replied: Hello good morning, yes ma'am see you soon!
01-29-2026 08:18 AM	Lailani Chehedeh	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-29-2026 02:26 PM	Lailani Chehedeh	Hello :) I hope all is well ! I have an earlier appointment at 4pm if Juliette is available?
01-29-2026 02:30 PM	Julietta Garcia	Julietta (Prim) Replied: Hi, yes that works for us See you at 4 then!
01-29-2026 02:30 PM	Lailani Chehedeh	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-29-2026 03:05 PM	Lailani Chehedeh	Perfect see you at 4 😊
01-29-2026 03:45 PM	Lailani Chehedeh	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=878547
01-29-2026 03:55 PM	Julietta Garcia	Julietta is CHECKED IN for: 4:00PM-1/29/2026 92523: Artic & Language Eval
02-27-2026 12:27 PM	Jazmin Lopez	Good morning! This is Jazmin from New Beginnings. I am reaching out to let you know that we received Julietta’s authorization and I will be her speech therapist. She was recommended to be seen 2 times per week for 30 minute sessions. I have 10:30am on Tuesdays and 10am on Thursdays available and I am able to start next week. Does this schedule work for you? 😊
02-27-2026 02:18 PM	Julietta Garcia	Julietta (Prim) Replied: Hello Jazmin! I'm Julietta's mother (Genesis) that schedule works fine for us. Can we start next week then? Also, are the sessions going to be in the same location as her evaluation?
02-27-2026 02:18 PM	Jazmin Lopez	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
02-27-2026 02:55 PM	Jazmin Lopez	Perfect! My office is located in the same location as her evaluation and yes we will be able to start this coming week if you’re available. I’m looking forward to meeting you both! 😊
03-01-2026 04:00 PM	Jazmin Lopez	Hi, this is a just a reminder that Garcia, Julietta has a Speech Therapy appointment on 03-03-2026 at 10:30 AM, and on 03-05-2026 at 10:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-02-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:30 AM. See you soon! - New Beginnings 🙂
03-03-2026 08:07 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:30 AM. See you soon! - New Beginnings 🙂
03-03-2026 10:15 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901070
03-03-2026 10:19 AM	Julietta Garcia	Julietta is CHECKED IN for: 10:30AM-3/3/2026 92507: Speech & Language Visit
03-04-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:00 AM. See you soon! - New Beginnings 🙂
03-05-2026 08:00 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:00 AM. See you soon! - New Beginnings 🙂
03-05-2026 08:27 AM	Julietta Garcia	Julietta (Prim) Replied: Good morning, I'm sorry but I have to cancel today's session due to a family emergency. Once again I apologize, we'll see you next week
03-05-2026 09:38 AM	Jazmin Lopez	Good morning, no worries at all thank you for letting me know. I hope everything is okay with your family. See you next week!
03-05-2026 09:45 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901034
03-05-2026 09:45 AM	Jazmin Lopez	Jazmin Lopez CANCELLED: 10:00AM-3/5/2026 92507: Speech & Language Visit
03-08-2026 04:00 PM	Jazmin Lopez	Hi, this is a just a reminder that Garcia, Julietta has a Speech Therapy appointment on 03-10-2026 at 10:30 AM, and on 03-12-2026 at 10:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-09-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:30 AM. See you soon! - New Beginnings 🙂
03-09-2026 06:32 PM	Julietta Garcia	Julietta (Prim) Replied: Hello! Just wanted to let you know I won't be able to take Julietta this week but her aunt is taking her in my place is that okay?
03-09-2026 06:54 PM	Jazmin Lopez	Hi! Yes, that’s totally okay as long as her aunt is 18+, she can bring her to the appointment. I just won’t be able to discuss what we did in therapy with aunt since she isn’t listed on the "Release of Confidential Information / Permission to Bring Patient to Therapy" form that you previously signed. I will have the front desk send you a new form via text so you can add her name. You can add 2 additional people to the list 😊
03-09-2026 06:55 PM	Jazmin Lopez	https://st-pros.com/newbeginnings/documents/03092026185537-NewBeginnings_Consent_Form.pdf
03-09-2026 06:57 PM	Julietta Garcia	Julietta (Prim) Replied: Perfect! Thank you ☺️
03-09-2026 06:57 PM	Julietta Garcia	Julietta (Prim) Replied: Loved “Hi! Yes, that’s totally okay as long as her aunt is 18+, she can bring her to the appointment. I just won’t be able to discuss what we did in therapy with aunt since she isn’t listed on the "Release of Confidential Information / Permission to Bring Patient to Therapy" form that you previously signed. I will have the front desk send you a new form via text so you can add her name. You can add 2 additional people to the list 😊”
03-10-2026 08:00 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:30 AM. See you soon! - New Beginnings 🙂
03-10-2026 10:15 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901071
03-10-2026 04:39 PM	Jazmin Lopez	Hi! 😊 I wanted to share a quick update about Julietta’s session today. During today’s therapy we focused on following simple directions and increasing Julietta’s use of words during play. We played with a farm set, velcro play food, and a puppet to keep the activities fun and interactive. With the farm animals, we practiced following directions that included spatial concepts like “in” and “out.” I modeled simple phrases while moving the animals and encouraged Julietta to follow the directions during play. For example, I modeled phrases like “Come in, cow / Ven adentro, vaca,” “Come out, cow / Sal afuera, vaca,” and “Put the cow in / Pon la vaca adentro.” With the play food and puppet, we worked on combining two words to communicate wants and needs. I modeled short functional phrases during play such as “More please / Quiero más,” “Eat broccoli / Come brócoli,” and “More food / Más comida.” Overall she participated well and was engaged in our activities today.
03-10-2026 04:40 PM	Jazmin Lopez	Also, the front desk will be sending you the form I mentioned to complete. We will need to delete the one we currently have on file. The current form has your name and Luis Garcia listed, so please add those again along with aunt’s name. Please let me know if you have any questions, thank you!
03-11-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:00 AM. See you soon! - New Beginnings 🙂
03-12-2026 07:53 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:00 AM. See you soon! - New Beginnings 🙂
03-12-2026 09:45 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901035
03-15-2026 04:00 PM	Jazmin Lopez	Hi, this is a just a reminder that Garcia, Julietta has a Speech Therapy appointment on 03-17-2026 at 10:30 AM, and on 03-19-2026 at 10:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-16-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:30 AM. See you soon! - New Beginnings 🙂
03-17-2026 07:55 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:30 AM. See you soon! - New Beginnings 🙂
03-17-2026 08:12 AM	Julietta Garcia	Julietta (Prim) Replied: Good morning! I'm so sorry I'm gonna have to cancel today's appointment Julietta got really sick and we had to bring her to the hospital she's being admitted due to low oxygen levels. Im not sure if we can make Thursdays appointment, we don't know how long we'll be here for once again my apologies.
03-17-2026 10:15 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901072
03-17-2026 10:17 AM	Jazmin Lopez	Oh no i'm so sorry to hear that :( Don't worry about this weeks sessions. I hope she recovers quickly!
03-17-2026 10:31 AM	Jazmin Lopez	Jazmin Lopez CANCELLED: 10:30AM-3/17/2026 92507: Speech & Language Visit
03-17-2026 10:31 AM	Jazmin Lopez	Jazmin Lopez CANCELLED: 10:00AM-3/19/2026 92507: Speech & Language Visit
03-19-2026 10:21 AM	Jazmin Lopez	Hi, just wanted to check in and see how Julietta is doing. I’ve been thinking about her and hope she’s feeling better!
03-19-2026 10:24 AM	Julietta Garcia	Julietta (Prim) Replied: Hello! We're still at the hospital but she's doing much better! Hopefully we'll get discharged today or tomorrow, thank you for your concern 😊
03-19-2026 10:48 AM	Jazmin Lopez	Oh yay! I’m so glad to hear that she’s doing much better 💜 I hope you both get some good rest. If she’s feeling up to it, I’d love to see her next week but no worries at all if she needs more time. Just let me know 😊
03-22-2026 04:00 PM	Jazmin Lopez	Hi, this is a just a reminder that Garcia, Julietta has a Speech Therapy appointment on 03-24-2026 at 10:30 AM, and on 03-26-2026 at 10:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-23-2026 06:31 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:30 AM. See you soon! - New Beginnings 🙂
03-24-2026 07:58 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:30 AM. See you soon! - New Beginnings 🙂
03-24-2026 10:15 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901073
03-24-2026 10:16 AM	Julietta Garcia	Julietta is CHECKED IN for: 10:30AM-3/24/2026 92507: Speech & Language Visit
03-25-2026 06:30 PM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled tomorrow at 10:00 AM. See you soon! - New Beginnings 🙂
03-26-2026 07:50 AM	Jazmin Lopez	Hi, this is a just a reminder that Julietta has a Speech Therapy appointment scheduled today at 10:00 AM. See you soon! - New Beginnings 🙂
03-26-2026 09:45 AM	Jazmin Lopez	Julietta Garcia : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=901037
03-26-2026 09:48 AM	Julietta Garcia	Julietta is CHECKED IN for: 10:00AM-3/26/2026 92507: Speech & Language Visit