Beyond the Spectrum Intake Form
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  • English (US)
  • Spanish (Latin America)

  • Beyond the Spectrum School Intake Form

    Thank you for your interest in our school. We proudly serve individuals ages 4 through 22+, and we look forward to learning more about your student! Once your form is submitted, you will receive a confirmation of receipt. Our academic team will then review your student's information, and we will contact you about further steps.

  • Please note that applications submitted without any supporting documentation will not be considered. If you encounter any issues uploading your documentation with this application, please email our Registrar at kathleen.seah@beyondthespectrum.org. We appreciate your cooperation!

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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Individualized Education Plan Information

    If your child has an IEP, we would like the most recent copy. If you know your Matrix score, please supply it along with the Matrix of Services paperwork. If you do not know the score or do not have this paperwork, Registrar Kathleen Seah will assist you with learning the score and obtaining the paperwork.
  • Does your student have an IEP (Individualized Education Plan)?
  • What is your student's Matrix Score?
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  • Funding Information

    For assistance with school funding, please contact our Financial Director, Peggy Caruso, at 941-447-8400.
  • Please select the funding you currently have for your student.

  • Intake Questionnaire

    At Beyond the Spectrum, we offer four specialized educational programs. Some questions may not be relevant to your child, but please answer those that are applicable to the best of your ability so we can better understand your student's individual circumstances, needs, interests, and goals. Thank you!
  • Please select any Developmental/Neurological Diagnoses that apply to your student.
  • Please select any Sensory/Motor Diagnoses that apply to your student.
  • Please select any Learning-related Diagnoses that apply to your student.
  • Please select any Behavioral/Mood Diagnoses that apply to your student.
  • If your student has any of these diagnoses, is he/she aware of them?

  • Medical Profile

    Please identify all medical conditions your child currently has or has had in the past.
  • Please select any of the following that apply to your student.
  • Does your student have an Epi-Pen for severe allergic reactions?
  • Is your student on a special/limited diet, or does your student have specific feeding needs?
  • If your student regularly experiences any of the following symptoms, please select them below.

  • Services & Therapies

    Please indicate the current services and therapies your student receives.
  • Please select the services your student receives below:

  • Academic Profile

    To the best of your knowledge, please circle what your child can do independently. Please note that this is not a comprehensive list of all academic skills, but rather a way for us to have an idea of your child's abilities.
  • Student's Independent Reading/Writing Skills
  • Student's Independent Mathematics Skills
  • Do you have a goal for your student to earn any of the following certifications?

  • Personality Profile

    Please respond to the following with what best applies to your learner
  • Student's Personality Traits
  • Does your student prefer to be alone or with others?
  • Does your student initiate interaction with parents/guardians?
  • Does your student initiate interaction with other adults?
  • Does your student initiate interaction with siblings?
  • Does your student initiate interaction with peers?
  • Communication & Hearing - Does your student have difficulty with any of the following?
  • Please select all that is true for your student:
  • Rows
  • Does your student have a one-on-one aide at school?

  • Behavioral Profile

    Please respond to the following inquiries to the best of your ability.
  • Does your student have a current behavior plan at school?
  • Does your student receive behavior services at home or in a clinic?
  • Can you, alone, take your student and another sibling/friend of the student into the community without difficulties?
  • Has your student been asked to leave a program or not come back for a following session?
  • Has your student displayed any of the following in the past year?
  • Is your student bathroom trained?
  • Does Beyond the Spectrum have your permission to contact previous schools, therapists, or service providers to learn more about your student?
  • Should be Empty: