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    intake form FOR literacy CONCERNS

    All information provided will remain confidential. You will receive a Confirmation notice on this page once it has been submitted. please make sure all boxes have been entered. Thank you.


    General patient Information



    Parent 1 contact information


    Parent 2 contact information

    If different than above
    If different than above.

     Family History


    Patient Medical history


    ACADEMIC CONCERNS




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Allison Winters
M.Ed., CCC-SLP. C-SLT
Shawnee, KS 66216
913-777-4757



What Clients Say
“Allison has been a critical part in helping my daughter learn how to read more efficiently and she is now reading above her 5th grade-level. I am so thankful for all she has done for our family.” -Amy 
 
“Not only were we able to schedule an evaluation with Mrs. Winters within 3 weeks of initially calling, she answered all of my questions so we knew exactly what to expect on the day of testing. She also set aside time for a separate 2 hour meeting for my husband and me explaining all of Nathan’s results and gave us a plan to help him with his reading!” -Nicki N.

"Mrs. Winters helped me a lot with my reading. At first I didn't like having to go see her every week after school but now I don't mind at all because I can read!" -Luke Z.

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