Therapy Interest Form - Cheshire Center

Empowering Your Child’s Voice—Every Step of the Way
Cheshire Center is a family-first pediatric speech therapy practice founded over 40 years ago by a speech-language pathologist who saw the need for children to receive therapy beyond the school setting. We serve children from birth to age 21 in homes, daycares, virtually, and our clinic in Greensboro—wherever works best for your family. We accept all Medicaid plans and most private insurances. Someone from our office will contact you within 2–3 business days about speech therapy!
Child's Name*
First Middle Last
Child's Date of Birth*
MM slash DD slash YYYY
Guardian (Your Name)*
Phone*
Email*
Comments
This field is for validation purposes and should be left unchanged.

Empowering Your Child’s Voice—Every Step of the Way