Thank you for choosing Pathways to Speech and Reading LLC to help meet your child’s speech, language and reading needs. I appreciate the opportunity to work with you and your child!  Please take time to fill out as much information as possible on the following intake questionnaire, as this information is important for guiding assessment and the direction of a therapy plan.

Speech and Language Intake Questionnaire

1.  Download  PDF form and fill out using free Acrobat Reader

If link opens a new tab or window with the form, please go under “File” at the top left of the page and “Save Page As” and save the file to your computer.   You can either print out the forms, or use Acrobat Reader to fill out on your computer.

2.  Fill out all five pages where applicable and resave

3.  Email your completed PDF form to


Please call with questions or for more information if you live in the following areas: Broomfield, Lafayette, Louisville, Superior, Boulder, Westminster, Thornton or Arvada. Call: 303-856-8817