Waitlist Sign-Up
Rise & Shine Speech and Language is currently accepting sign-ups for November 2025. For questions, please contact pediatric speech-language pathologist, Krista Dotson, at krista@riseandshinespeechtherapy.com or 210-201-6677. Sign-ups for the November 2025 waitlist do not guarantee therapy placement. Acceptance depends on factors such as your child’s diagnosis, location, and availability of spots. Completing this form ensures your information is on our waitlist, and we will contact you within 2 business days to discuss your child’s needs.
Parent/Guardian Name
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First Name
Last Name
Child's Name
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First Name
Last Name
Parent/Guardian Email
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example@example.com
Parent/Guardian Phone Number
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Please enter a valid phone number.
Child's Birthdate
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Month
-
Day
Year
Date
Parent/Guardian Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Comments/Questions:
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Preferred Start Month/Notes
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Preferred Method of Contact
Phone
Text
Email
I understand this is a waitlist for services beginning November 2025 and that I will be contacted by Rise & Shine Speech and Language to discuss my child's current needs.
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Yes
Signature
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Date
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Month
-
Day
Year
Date
Continue
Continue
Should be Empty: