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Request Form

Please fill out the form below with your questions for our Speech and Language Pathologist. Janice Simons M.S., has over 20 years of experience working as a Speech and Language Pathologist and will be able to offer you expert assistance which will enable you to select the equipment most appropriate for the disabilitie(s) you are working with.

All responses will be sent via e-mail, so please make sure to fill out this form completely.

Name
City State
Telephone:
E-mail:
Setting: Pre-school Elementary Secondary College/University    
Rehab/Nursing
Functional Living
Other (describe below)  
 

Question:

Please submit your question: