Pilot application

LumaLayer SLP Pilot — Application

Takes about two minutes. Tell us who you are and acknowledge how AI drafts are used. After you're approved, we'll walk you through a short setup on your first sign-in to tailor LumaLayer to your setting, payers, and documentation workflow.

Fields marked with * are required.

Do not include client, patient, or student names, DOB, MRN, addresses, or other protected information in this application unless LumaLayer has specifically requested it through an approved secure process.

Section 1

Applicant information

Full name *

Email *

Phone

City / State

Practice, agency, or district name *

Website (if applicable)

Brief description of your current SLP work

Section 2

AI use acknowledgement

Please acknowledge all of the following.

AI outputs are drafts that I must review, edit, and approve before use.LumaLayer does not replace my clinical judgment or professional responsibility.I will not place live PHI/student data into LumaLayer unless my organization, payer, or compliance process has approved it.I will not enter full patient/student names, DOB, MRN, addresses, or other identifiers unless specifically approved.Draft translations require review according to my organization, payer, or legal language-access policy.

All acknowledgements must be checked before submission.

Questions or concerns before pilot approval

Section 3

Applicant signature

By signing below, I confirm the information provided is accurate to the best of my knowledge and I understand pilot approval may require additional review, documentation, agreements, or employer/agency authorization before live client, patient, or student data is used.

Type your full name as signature *

Date *

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