Speech-Language Therapy Interest Form

If your student receives speech-language services throughout the school year, and is local to GRAVES COUNTY, KENTUCKY, I can help them continue their progress this summer! I'm a Kentucky and ASHA-licensed SLP with 9 years of school-based experience (learn more about me here). 

Availability is limited, so if you are interested, please fill out this form ASAP.

2023 Summer Availability: Tuesdays (June-July). depending on interest, I may offer one other day as well.

Ages: 5-14

Pay: Private pay only (cash/check/card). I cannot accept insurance at this time.

Location: The Graves County Public Library (Kentucky) allows me to book a small room if given enough advance notice. Public locations preferred.

*Note: I cannot accept McCracken County students at this time because I work in the district.

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Adresse e-mail *
Parent/Guardian Name (Firstname Lastname) *
Are you local to Graves County, Kentucky? *
Does your child attend McCracken County schools? *
Are you interested in your child receiving speech-language services? *
How did you hear about me? *
Additional Information:
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