Thank you for your interest in working with us!
Participant's Full Name:
Participant's Native Language:
Does the participant speak any other languages?
Does the participant have speech or language difficulties? If so, please describe them:
If known, what is the cause of the speech or language difficulties (e.g. cerebral palsy, stroke)?
If the participant uses an AAC device, what is the brand and model?
If you are not the potential participant, what is your name and how are you related?
Is there any other information you would like us to know?
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