FREE Speech & Language Screenings Information Form
Easy Peasy Speech is excited to offer FREE speech & language screenings. 

Information about the screening: 
  • Screenings are 15 minutes in length. 
  • They take place at our Cranberry Township office (1187 Freedom Road Suite C101, Cranberry Twp., PA 16066) or virtually on Zoom. 
  • A parent or guardian is required to attend the screening with the child. 
  • Screenings are completely free and there is no obligation for you. 
  • Screening will be completed by a state licensed and nationally board certified Speech-Language Pathologist through Easy Peasy Speech.
To register, fill out the form below to choose your preferred day of the week/time options. Someone from our offices will follow up with you to confirm. 

Don't see a time that works for you and your child? Send us an email easypeasyspeechpgh@gmail.com for an alternate time. 

Sign in to Google to save your progress. Learn more
Email *
Child's Name: *
Child's DOB: *
MM
/
DD
/
YYYY
Name of person providing this information and relationship to the child: *
Contact Phone Number: *
What type of screening would you prefer? *
What day of the week is best for you and your child? *
Required
What time of day is best for you and your child? *
How did you hear about Easy Peasy Speech?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.