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Contact Information

(204) 474-8798
Mailing Address
Dr Melanie Soderstrom
P404 Duff Roblin Building, University of Manitoba
190 Dysart Rd
Winnipeg, MB    R3T 2N2

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Child's Info

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Other language(s) spoken to child (e.g. “10% French”)

Multiple birth? (if yes, please specify type)

If child was born early, please specify due date
Any cognitive, language, or physical deficits?

Siblings? (If any, specify gender and birth date)

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