More Than Words Pre-Screening

Your Name (required)

Your Email (required)

Phone: (required)

Tell Us A Little About Your Child

1. My child doesn't seem interested in interacting with others. (required)
YesNo?

2. My child plays with objects and toys differently than other children. (required)
YesNo

3. I'm having trouble motivating my child to communicate.
YesNo

4. I could benefit from strategies to help improve my child's play skills.
YesNo

5. My child is currently enrolled in speech and language services.
YesNo

Anything else we should know?