Early Expressions Preschool Speech-Language Service Request Form

Getting Started

By making this service request, you, your family doctor, or child care provider are indicating there are concern's about your child's speech and language skills. By making a referral to this program, you are requesting a speech and language assessment by a speech-language pathologist. If you need help making a service request, call KidsInclusive Early Expressions Preschool Speech-Language Program at (613) 544-3400 ext. 3175 (then press prompt 3 for Early Expressions) or at 1-855-544-3400, Monday to Friday, 8:30 a.m. to 4:30 p.m. This request form may take up to 20 minutes to complete. Thank you for your time. This information helps us plan for your first appointment. We may call you before the appointment if we have questions about the information you have provided.