Get Speech Therapy Parent Questionnaire - Speech Spa

Filling out the Speech Therapy Parent Questionnaire - Speech Spa is a crucial step in establishing a tailored therapeutic plan for your child. This guide provides step-by-step instructions to ensure you complete the questionnaire accurately and thoroughly.

Follow the steps to successfully complete the questionnaire.

1. Press the ‘Get Form’ button to access the Speech Therapy Parent Questionnaire and open it in your preferred online editor.
2. Begin with the 'Client and Family Information' section. Enter your child's name, the name they go by, their date of birth, age, and gender. Also, provide the names of both parents, your address, and contact information, including home and cell phone numbers, as well as your email address.
3. In the same section, indicate who referred your child for therapy and provide contact information for an additional person to reach in case of an emergency. List siblings and their details—name, age, and gender.
4. Next, address any family history of speech, language, or hearing difficulties, and specify the languages spoken within your family.
5. In the 'Birth / Medical History' section, describe any relevant medical history and allergies. Note if your child has undergone tonsil or adenoid removal, had ear infections, or if their hearing has been tested, along with the results.
6. Proceed to the 'Speech/Language History' section. Indicate if your child has previously received speech therapy or other evaluation services, and provide details if applicable.
7. Address your child's awareness of any speech or language difficulties, how they communicate, and whether their speech is understandable to different people.
8. In the 'Educational / Social History' section, fill in your child's school information, type of program, and classroom teacher. Indicate any assistance or special education services your child receives and describe their academic strengths and challenges.
9. Continue to the 'Feeding / Oral-Sensory' section. Note any past or present feeding problems, difficulties with chewing or swallowing, and personal eating habits.
10. Finally, include any additional information you find relevant regarding your child’s history and state your primary goals for their speech therapy.
11. Complete the form by providing your name and relationship to the child and review all entries for completeness and accuracy.
12. Conclude by saving the changes, downloading, printing, or sharing the completed questionnaire as needed.

Start filling out the Speech Therapy Parent Questionnaire online today to support your child's therapeutic journey.