Online Referral Form

This on-line referral form is only for families who want to receive speech and language services from tykeTALK.

If your child is attending or registered in school, please call us directly (519-663-0273) to determine if your child is eligible for services through tykeTALK.

Information About You

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Information About the Child

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Child's Parent/Guardian

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Siblings

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Secondary Contact

Background Information

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