Client Contact Form

Client Contact Form
Name of Contact Person*

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School, if applicable
I am interested in information for services from*
If you are interested in services from The Reading Center, please select all concerns from the options below.

reading concerns / dyslexiawriting concerns / dysgraphiamath concerns / dyscalculia
If you are interested in services from Cognitive Connections Clinic, please select all concerns from the options below.

Brain fog / forgetfulnessTask initiationOrganizational skillsWorking memoryFlexibilityAutism or other neurodivisitiesCognitive declineEmotional control and self regulationTime managementImpulsivity or lack of sustainable attentionDementiaSensory concernsOther
I'm interested in testing:

readingwritingmathacademicsautismattention deficitcognitive
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