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* 1. Your Name, Your Child's Name, Child's Date of Birth, Name of Daycare

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* 2. Type your name if you consent to your child being screened by Thrive Speech Therapy 

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* 3. Your Phone Number and e-mail address

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* 4. Does your child understand words for some primary colors and simple shapes?

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* 5. Does your child talk about daily activities using about 4 sentences at a time?

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* 6. Does you child answer "who", "what", and "where" questions?

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* 7. Does your child use pronouns like (I, you, me, we, and they)?

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* 8. Is your child able to produce k, g, f, t, d, and n sounds and most vowels?

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* 9. Does your child use make-believe play and use verbalizations during play?

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* 10. Does your child follow simple commands if the item is out of sight?

T