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Speech-Language Services Form

Please fill out the form below to let us know more about your child and his or her therapy needs.

The Joy School therapy rates:

  • $140 an hour for speech and language therapy sessions

A TJS Speech-Language pathologist will contact you to discuss your child's therapy needs. If you have any questions, please contact Meredith Hibbetts at mhibbetts@thejoyschool.org.

You will receive a confirmation email after submitting this form.

Required

Student's First Namerequired
Student's Middle Name (optional)
Student's Last Namerequired
Must contain a date in MM/DD/YYYY format
Student's Genderrequired
Student's Current Graderequired
 
Contact Information
Prefixrequired
Parent's First Namerequired
Parent's Middle Name (Optional)
Parent's Last Namerequired
Please select which type of therapy you are interested inrequired
Number of days a week you would like your child to receive therapyrequired

 

Testing & Documentation

You may submit copies of a recent report card or reports for any testing completed within the last two years to help give our speech-language pathologists background information about your child.

Attach up to 1 file with a maximum size of 20MB
No file chosen
Attach up to 1 file with a maximum size of 20MB
No file chosen
Attach up to 1 file with a maximum size of 20MB
No file chosen

Click here to review The Joy School's Therapy Policies.

Without parental agreement to the Therapy Policies, we cannot provide our speech and language therapy services to your child.

I have read and understand the Therapy Policiesrequired
If you have questions or concerns about The Joy School's Therapy Policies, please contact Renee Nichols, Program Coordinator, at rnichols@thejoyschool.org.

When you have completed this form, please be sure to click the submit button below.