Let's Connect

I’d love to hear from you. Whether you have questions about speech therapy, myofunctional therapy, or aren’t sure which one fits your needs, reach out and let’s talk through it together.

Carla Dopko, MSc., R.SLP

Registered Speech-Language Pathologist

Consultation Form

Clients Full Name

Parent / Guardians Full Name

Phone

Clients Date of Birth

Reason for Referral

Referring Practitioner

Referring Practitioner's Email

Date of Referral

Additional Information