Summer Speech Therapy
Please fill out the following, then you will be prompted to schedule your free consultation to discuss next steps for your child! 
E-mail *
Parent name *
Parent email *
Parent phone number *
Child's name *
Child's age *
Child's location (city/state) *
Which program(s) are you interested in?  *
Obligatoire
Which weeks are you interested in having your child attend? Select all that apply. This does not commit you to anything. *
Obligatoire
Does your child already have communication goals on an IEP? *
What accommodations does your child require (physical, communication, or behavioral)? 
Would you like to request an evaluation?  *
How did you hear about us? *
What goals do you have for your child this summer? *
What other questions do you have? 
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