Central Maryland Speech Therapy Programs Interest Form
When the Loyola speech and communication clinic in Columbia announced it was closing, we knew we had to step up for our community. Not only did many with Down syndrome lose their affordable accesse to speech and communication therapy, but also graduates of the Loyola Speech Language Pathology program would no longer have as much access to working with people who have Down syndrome. 

So - here we are. We've coordinated a supervising SLP in Megan Hayes of Sunflower Speech Therapy LLC, and two graduate students for the Spring 2024 semester to provide you with services! Indicate your interest below and we'll be in touch to finalize details.

The fee will be $100 for a 12-week session, with a confidential scholarship option available as always. 
Sign in to Google to save your progress. Learn more
Person with Down syndrome or other disability: Name of potential client *
Person with Down syndrome or other disability: Age of potential client this term *
If applicable: parent/guardian/support staff name:
If applicable: parent/guardian/support staff email:
Are you available/interested in speech/communication services...
 *
Required
When are you available for a 45-minute session on the days/locations you selected above? Select all that apply.
 *
Required
Are you able to commit to a 12-week term? The graduate students need their hours. (This is why we are choosing not to focus on individual therapy.)
 *
Required
Do you/the potential client use a communication device right now?
 *
Required
Check all that apply about you/the potential therapy client:
 *
Required
Has your child been evaluated in the areas of speech and language? If yes, please share the date of their most recent evaluation and which areas were evaluated.
What else should we know? Tell us here:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms