Case History Questionnaire

Case History Questionnaire
Time
:

Family Information

Birth History

Feeding History

Motor Milestones

Language Milestones

Medical History

Audiology

Please provide details • family history • what type of stutter (does he stutter at the beginning of sentences/]? Does he/she try to say something and nothing comes out?) etc • When is it worse? (e.g. tired/ excited).
Please note that we are not an NDIS provider
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Perth Speech Therapy has an Alfred Cove clinic. This clinic also provides mobile services to schools, day care centres and homes.

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Clinic Location: Alfred Cove