ABC Social Stars

ABC Social Stars is a speech therapy group for children between the ages of five and 10 years old. The focus of the group is to help build social, communication and play skills by teaching strategies, and by helping in developing skills through fun and engaging activities.

Sign in to Google to save your progress. Learn more
Child's Full Name
Child's Age
Child's School and Grade
Number 1: Parent/Caregiver Full Name and Telephone Number


Number 2: Parent/Caregiver Full Name and Telephone Number 
Home Address
Primary Email Address
Second Email Address
Does your child have a diagnosis?
Did your child have a speech therapy assessment recently? If so, please describe the clinical impressions. 
What languages does your child speak and understand?
Please describe your child's strenghts.
Please describe why you registered your child to this camp?
Please describe any specific interests that your child may have. 
Can your child be agressive? 
Can your child follow group instructions and directives? 
Is there anything else that you'd like to share that would help us make this program a success for your child?
What are some strategies that can help your child regulate when he's/she's feeling anxious/dysregulated?
Does your child have any allergies? If so, please list all allergies and the severity.
Please list and describe any other medical conditions that your child has that would be important for the clinicians and educators to know.
I would like to share/know....
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ABCommunication. Report Abuse
Google Forms