Social Skills Group Registration Form
Social Skills small groups will be 45 minute long, drop off, sessions that include CDC guided protocols: students and clinicians will wear masks and thorough cleaning will occur before and after each session.  Groups will occur at our clinic at 3068 38th st, Lower level.  Each group will have no more than 3 young children and 1 Speech therapist.  Please register here:
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What is your child's first and last name? *
What is your child's date of birth? *
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Parent Email Address:
Parent phone number:
Which group would you like to register your child for? *
What are your social language goals for your child? *
If you would like us to reach out to a current provider or teacher please let us know and we would be happy to speak with them about their goals for your child.  (Note the name, contact info, and capacity in which they work with your child)
What are your child's interests/hobbies? *
Is there anything else you would like us to know about your child? (please note medical conditions and any allergies here)
How will you be paying for the social skills group (ten session package is $450, unfortunately we cannot refund unattended sessions) *
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