Case History Form The information requested on this form will assist this program in understanding your families concerns regarding your child’s communication. If we can help filling out this form, please call us.

Permission Form  To best serve your child and family, it may be necessary to obtain from and share information with other individuals or agencies who are involved with your child. Information to be shared is limited to what is necessary to enable us to work effectively with you and your child. (e.g. goals, observations, assessments, reports, etc.)

Rights and Responsibilities The Surrey Early Speech and Language (SESLP) is committed  to full partnership with parents and caregivers of the young children we serve. Our comprehensive family centered program encourages parents and caregivers to work in partnership with us in the development of their individual family service plans (IFSP). Opportunities for ongoing feedback from our partners are an integral part of our programs and services. The Surrey Early Speech and Language Program recognizes the diversity of the population it serves.

Photo Video Release Form