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Speech Start provides
Pediatric Speech, Language, Feeding, Occupational, Academic
services for individuals ages 0 to 21+
Classes & Programs
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Administrative Staff
Occupational Therapists
Speech-Language Pathologists
News
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Welcome Packet
Individual Therapy Request
Group Therapy Registration
Winter Group Therapy Registration
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Administrative Staff
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Winter Group Therapy Registration
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GROUP THERAPY REGISTRATION
Child's Name
(Required)
First
Last
Child's Date of Birth
(Required)
MM slash DD slash YYYY
Child's Age
(Required)
Please enter a number less than or equal to
99
.
Parent/Guardian's Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Please select the groups you are interested in below
(Required)
Babbling Bunch - $400.00
Playing with Peers 1 - $400.00
Playing with Peers 2 - $400.00
Teamwork Titans - $400.00
Socializing with STEM - $400.00
Social Butterflies - $400.00
Young Adult Group - $400.00
Total
Please note any significant information regarding your child (for example, allergies, potty training, etc.)
(Required)
Please leave your questions, comments, or concerns below. Our office staff will contact you to discuss
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