Client Contact Form

Client Contact Form
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Child's Name
Child's Age
Child's Grade
What concerns do you have regarding your child?

DyslexiaDysgraphiaDyscalculiaAttention/FocusProcessing DeficitsDevelopmental challengesLong-term or short-term memory concernsOther
Thank you for contacting The Reading Center and Cognitive Connections Clinic! Someone will reach out to you soon.
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