RES Request for Early Learning Screening

The Early Learning Program (ELP) is tailored to assist students who experience speech delays (including both articulation and expressive/receptive language issues) as well as those facing medical, behavioural or emotional challenges. This exceptional program is both goal-oriented and suited to the developmental needs of its students. Our team, comprised of compassionate professionals, is committed to fostering your child's development and achievements.

We invite children aged 2 years and 5 months to 5 years to explore the possibility of joining ELP.

To initiate the assessment process, please complete the following questionnaire in full.

At this point we do not need you to complete a New Student Registration form.  Following your child's screening, we will reach out to inform you about eligibility for the program. If your child qualifies, you will be prompted to complete the New Student Registration form.

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Email *
Parent Name *
Parent phone number *
Home mailing address *
Child's Name *
Child's birthday *
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Child's age as of August 31 (years & months) *
Gender of child *
Which Early Learning Program are you hoping your child will attend? *
Has you child had an eye exam in the last 12 months? *
Has your child had a hearing exam in the last 12 months? *
Does your child have any kind of existing diagnosis from a doctor?  If so, please give details. *
Has your child received or are they currently receiving any speech services from AHS?  If so, which speech pathologist? *
Are there any concerns about your child's development (aggressive behaviours, holds stool, emotional concerns, extreme shyness etc.) that we need to be aware of? *
Do you have any concerns about your child's motor skills (do they need significant help getting dressed, concerns with balance, or concerns with toileting etc)? *
Does your child have any difficulty learning or understanding new things? *
I give permission for my child to undergo relevant  screening/testing as required. *
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