Please complete the form below to grant permission and authorize a comprehensive speech and language evaluation, and/or treatment (as needed) for your child. Speech-language evaluations consist of standardized testing, informal and formal observations, and clinical judgment.

Completing this form authorizes The Speech and Language Therapy Center, LLC, to evaluate and/or provide the necessary speech and/or language treatment/therapy/services to your child. Treatment is based upon the findings of the evaluation and the recommendations of the responsible speech-language pathologist.