Request an Appointment

Call or text: 702-518-3368

Patient Name*

Patient Birthday*

Parent Name

Email*

Phone*

How should we contact you?*

Call

Text

Email

Main Concerns*

Ties

Breast/bottle feeding

Speech issues

Sleep/breathing issues

Crowded teeth

Bodywork/CST

Please let us know why you would like an appointment.*

Does the patient have a current speech, feeding, or myofunctional therapist?*

Yes

No

If yes to above, who is the therapist?

What state are you in?*

NV

UT

Other

Does the patient have Medicaid?*

Yes

No

Who referred you? How did you find us?*

Call or Text: 702-518-3368

Address: 6348 S Rainbow Blvd #110 Las Vegas, NV 89118

Hours: M/W 9-5, F 9-3

Contact Us

Call or text: 702-518-3368

6348 S Rainbow Blvd #110 Las Vegas, NV 89118

Hours: M/W 9-5, F 9-3

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