THE LANGUAGE AND BEHAVIOR CENTER

Social Skills Groups

Services to support your child's social-emotional development

For New Clients

TLBC is currently accepting applications for Spring 2022 Social Enrichment Groups. This session will run from February 7 - April 29.

AM Session: 10:00AM - 12:00PM

Cost: $2400 for the full session billed monthly

PM Session: 2:00PM - 4:00PM

Cost: $2400 for the full session billed monthly

Please indicate which group your child is applying to attend:

Social Enrichment Group:

Monday - Friday 10:00AM - 12:00PM

Monday - Friday 2:00PM - 4:00PM

Your Name

Email Address

Phone Number

Child's Name

Child's Date of Birth

Address

Name of School (if in school)

Please indicate any food allergies or other medical conditions we should be aware of:

Other Information: Please include any information you think we should know about your child that we haven't asked you about in this intake form.

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!