Register to be on our list

Please fill out this form to complete your registration.

One of our team members will contact you to give you an appointment as soon as possible.

info@cliniqueiuvo.ca
(514) 242-7012

7655 Newman Boulevard
Suite 185
LaSalle, QC H8N 1X7

Client's Name (First and Last Name)

Date of Birth

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Service Wanted

Preferred Language for Services

Name of School (if child is of school age)

Message

Please indicate the services you are inquiring about, as well as difficulties you/your child are experiencing relating to speech-language pathology

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Yes, I have read and I accept the Confidentiality Policy