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Contact Information

Email
info@babylanguagelab.ca
Telephone
(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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Parent's Info

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Child's Info*

Child's first name

Child's last name

Child's gender

Child's date of birth
     
Primary language spoken to child

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)

* We use child info to determine if your child is eligible for our studies. This is not a secure web form. If you prefer, we can collect this information over the telephone. Call us at 204-474-8798 or leave us your telephone number to contact you. These fields may be left blank.

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