Contact Us

We want to hear from you.

We are happy to provide in-home and community-based therapy services in Northern Bergen County and Northern Essex County, New Jersey.

Use the form below to tell us about your primary concerns and how we can help. You will receive an email to schedule and confirm your phone consultation within 2 business days.

Caregiver's Name

First Name

Last Name

Child's Name

First Name

Last Name

Child's Date of Birth

YYYY

Phone

(###)

###

####

Town of Residence

Primary Concerns

How did you find us?

If "other" or "referral", please list here.

Please acknowledge the following:

I understand that Koze Speech Therapy only provides in-person services in select areas in Bergen County and Essex County, New Jersey.

I understand that if I live outside of Bergen County or Essex County, New Jersey, Koze Speech Therapy may be able to provide me with virtual visits.

I understand that Koze Speech Therapy is a private pay practice, does not participate with any insurance providers, and is considered an "out-of-network" provider.