Skip to content
Interest Survey for Speech and Language Enrichment Program with Licensed Speech-Language Pathologist
1.
How interested are you in enrolling your child in a speech and language enrichment program?
Very interested
Somewhat interested
Not interested
2.
Which locations would you prefer for the program? Select all that apply.
Public space
Home
Daycare
3.
What time of day would be most convenient for you for the program?
Morning
Afternoon
Evening
4.
Which days of the week would work best for you? Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
5.
What would be an acceptable cost per session for you?
6.
Would you be interested in a Spanish or bilingual version of the program?
Yes, Spanish
Yes, bilingual
No, English only
7.
How important is it for you to receive a newsletter detailing session activities and home reinforcement tips?
Very important
Somewhat important
Not important
8.
Please provide any additional comments or suggestions you have about the program.