MES Early Learning Program Screening
The Early Learning Program (ELP) is designed for and intended to support students with delays in speech (articulation and expressive/receptive language) as well as children with medical or behavioural challenges. It is an amazing program that is goal focused and developmentally appropriate for the students. We have an incredible team of caring individuals dedicated to your child's growth and success! 

We encourage all children currently between the age of 2 years 5 months up to 5 years to take this opportunity to come see us to see if they qualify for ELP. 

Please fill out ALL the information asked in the questions below in order to have your child assessed by our wonderful speech team. Once we recieve the information below, we will arrange a time for you to bring your child to the school to meet with our speech language assistant, Michelle,  and pathologist, Julie. 
Sign in to Google to save your progress. Learn more
Email *
Parent Name *
Parent phone number *
Home mailing address *
Child's Name *
Child's birthday *
Gender of child *
Which Early Learning program are you hoping your child will attend?
Clear selection
We run a morning and an afternoon session of ELP. Which would work best for you and your family? *
Has your child had an eye exam in the last 12 months? *
Has your child had a hearing exam in the last 12 months?
Does your child have any kind of existing diagnosis from a doctor? If so, please share what that is.
Has/Is your child receieved any speech services from AHS? If so, which speech pathologist?
Is there anything that you are concerned about with your child's development or speech that we need to be aware of?
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Westwind Staff. Report Abuse