Overcoming Stuttering - Contact Form

Schedule Your FREE Consultation
With A Fluency Counselor

A fluency counselor will contact you by telephone within 2 business days or less to evaluate your needs and make appropriate recommendations. You may also phone us directly at 1-800-221-2483, Monday-Friday, between 10AM and 5PM Eastern Time. Remember! Don't worry about stuttering with us on the phone - We're used to it!

Preliminary Profile
List any or all sounds you tend to stutter on the most frequently:

If specific words consistently give you more trouble than others, list them here:

What are some of your most problematic speaking situations:

Describe some of the speech therapies you may have had previously:

Select your age range:
Under 18 19-29 30-50 51-65 Over 65

What type of work do you do (If you are unemployed and/or a student, please indicate such accordingly)..

Contact Information

Last Name:
First Name:
Email Address:
Address Line 1:
Address Line 2:
City: State:
Country: Postal Code:
Phone Number:
The best time to call the above number is between: and
Alternate Phone Number: (*optional)
The best time to call the above number is between: and

©2003-2006, National Center For Stuttering. Equipment is FDA registered for the treatment of stuttering. Program purchasers are provided with a Fluency Enhancer, Motivaider, 2 headsets, an assignment manual, access to a user's support group, and 6 months worth of telephone support and counseling. Package may be returned within 30 days for a full refund if not entirely satisfied. Service is available worldwide. Health insurance coverage may vary.