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Diagnosis

What are your child's diagnoses?

  • Autism/Spectrum Disorders
  • Developmentally Delayed
  • Pervasive Developmental Disorder
  • Speech/Language Impairment¬†
  • Traumatic Brain Injury
  • Other (please use Diagnosis comments below)
  • Speech/Language Impairment
Diagnosing Clinician and Location
Diagnosis Comments
Please give a short description of your child's current abilities and needs including specific areas that you'd like addressed (daily living skills, communication, behavior, social skills, etc.)
Availability

Which days and times will your child be available for services?

M
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • T
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • W
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • Th
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • F
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • Sat
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  • Sun
  • 8 AM
  • 9 AM
  • 10 AM
  • 11 AM
  • 12 PM
  • 1 PM
  • 2 PM
  • 3 PM
  • 4 PM
  • 5 PM
  • 6 PM
  •  
    Availability Notes
    Please elaborate on your child's schedule (comment on naps, school, private therapies, other supports, afterschool activities, etc)
    Locations

    Which location is nearest you?

    • Eau Claire
    • Green Bay/Appleton
    • Madison
    • Milwaukee
    • New Richmond