Contact Us

23 West 3rd Street
Lexington, NC 27292

Phone: (336) 960-3281
Fax: (336) 860-1654

Email: info@kidsadvantagetherapy.com

I am concerned about my child's speech/language.

Once we receive your information, someone from our office will call you.

Child's Name

First Name

Last Name

Child's Date of Birth

YYYY

Child's Insurance Company

Your Name

First Name

Last Name

Relationship to Child

Phone Number

Concerns (check all that apply)

Speech Intelligibility

Receptive Language

Expressive Language

Social Communication Skills

Fluency/Stuttering

Any other pertinent information (medical dx, previous therapy, etc.)