Early Intervention Red Flag Checklist

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Red Flag Checklist

For parents of children around age 3 · Speech, Social, Play, Emotions & Motor Skills

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Parent Information

Please fill in your details so we can follow up

How to use this checklist: Tick any item that applies to your child regularly or consistently. If you tick 3 or more items in any one area, we encourage you to speak with a professional.

Speech & Language

Tick items that apply regularly or consistently

0 red flags selected

Social Skills

Tick items that apply regularly or consistently

0 red flags selected

Play

Tick items that apply regularly or consistently

0 red flags selected

Emotional Regulation

Tick items that apply regularly or consistently

0 red flags selected

Motor Skills

Tick items that apply regularly or consistently

0 red flags selected

Review & Submit

Review your responses before submitting

Summary: Below is a summary of the red flags you've identified. If you ticked 3 or more items in any one area, we encourage you to speak with a professional.

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Total Red Flags
0
Areas of Concern

Remember: This checklist is not a diagnostic tool. Only a qualified clinician can assess your child.

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Thank You!

Your checklist has been received successfully. A specialist will contact you soon.

Your Contact Information

Parent Name
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Email
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Phone
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Child
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What Happens Next

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Review

Our specialists will review your checklist within 24 hours

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Contact

We will reach out via your preferred contact method

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Consultation

Schedule a free initial consultation if needed

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Support

Early support makes a real difference — don't wait!