Phone: 904-721-4122

Questionnaires

Before your consultation, you need to fill out a Questionnaire for Speech, Language or Learning Disabilities. Choose either the Adult or Child Questionnaire. Please bring all printed documents with you to your consultation.

NOTE: When you click on one of the links below it will open in a new tab. From there, you can fill out the Questionnaire online, then print it out.
NOTE: When you click on the link below, it will open in a new tab. From there, you can check the boxes on the Checklist, then print it out.
Adult Questionnaire for Speech, Language or Learning DisabilitiesChild or Adolescent  Questionnaire for Speech, Language or Learning Disabilities
Signs of Processing Deficits Checklist

Is your child struggling in speech, language or learning? Have you worked with your child and is he/she still struggling? He/She may have a Processing Disorder. It could be a speech disorder, language disorder or phonological disorder. The most important question is, “What is the root problem?” It could be an Auditory or Visual or Motor Processing Disorder. Check the signs that apply to your child. If there are many, a thorough Auditory & Visual Processing Screening should be seriously considered. Click the link above for the Signs of Processing Deficits Checklist.

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