Registration Form - Spanish language and speech support

Spanish language and speech support

Thank you for choosing Words in Motion!

Program Fee

First-Time Assessment: $110/hr
Follow-Up Sessions: $95/session
10-Hour Package: $80/hr — single payment of $800 (materials included)

Additional Rates:

Travel time beyond 20 minutes billed at half the hourly rate, if needed.

Payment is made via monthly e-transfer to c.vallin@wordsinmotionbc.com.

For more details about our approach, visit our program page.

By completing this form, you confirm that the information provided is accurate.

Signee Information

First Name *

Last Name *

Phone *

Email Address *

Address *

Province *

Postal code *

Special needs, concerns or gifts of my child: *

Languages Spoken at home:*

Expectations from the support language therapy? *

What are your main concerns about your kid's language and speech development? *

Please enter participants' full names:

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.