Family Needs Assessment
REQUEST FOR SUPPORT
Parent/Guardian Name:
Child(ren) Name:
)
Are your children victims of discrimination in school?
Please Select
Yes
No
If yes, Where?
Are you already receiving help?
Please Select
Yes/Si
No
If yes, from who?
Would you like an appointment to discuss your issue with one of our child advocates ?
Please Select
Yes
No
Would you like a lawyer referral?
Please Select
Yes
No
Lawyer referrals are made after speaking to one of our child advocates who will evaluate your situation to offer you the best support.
Please explain what happened, who was involved, and what you have done to resolve the issue prior to contacting us? Also indicate if you contacted any other advocates or organizations for help and what the response was. Mention any evidence you have collected in support of your discrimination claim...
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