Patient's Name* First Last Has Any of the Patient's Information Changed?Phone NumberAddressInsuranceUpdated Phone NumberUpdated Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Interested in Learning About our Specialized Group Thereapy Options? Social Group Young Talkers Group Handwriting Group Sensory Motor Group Social group is a 6 week group focusing on facilitating and strengthening social and turn taking skills. The group will focus on peer interaction, which will be fostered and encouraged from the leading therapist. The group is one hour in duration: 45 minutes of social peer interactions and 15 minutes of parent education provided with exercises for home.Young Talkers is a 6-week group focusing on early developing communication skills including speech sounds/intelligibility, receptive and expressive language, and play/social interactions. This group is one hour in duration: 45 minutes of structured group activities and 15 minutes of parent education providing tips and techniques to support speech and language growth at home.Handwriting group is a 6-week group focusing on facilitating and strengthening good handwriting characteristics, as well as mature grasp development. The handwriting group uses the Handwriting Without Tears writing program. The group is one hour in duration: 45 minutes of facilitated handwriting instruction with peers and 15 minutes of parent education provided with handouts and exercises for home.Sensory Motor Group is a 6-week group geared towards children with mild to moderate sensory motor deficits, but will be modified for the needs of all group participants. This group is on hour in duration: 45 minutes of facilitated sensory motor tasks with peers and 15 minutes of parent education provided with handouts and exercises for home.