Client Background Information: Child Age 0 – 5

Please complete one of the Client Background Information forms below. Once completed and submitted, our clinic director will review the information within a timely manner. You will be contacted by one of our team members shortly to book your appointment.

Feel free to call us directly to book an appointment at 403-455-4072

Speech and Language History



Social/Play History

Prenatal and Birth History

Self Help Skills


Additional Comments