Teach Together Pre-Consultation Form

Teach Together Pre-Consultation Form

Before we get started, please share some information that can best guide our next steps!
Let's get to know each other a bit more.

Share as much or as little as you would like!
Name*

First NameLast Name
Email*
example@example.com
Name of child(ren)*
Age(s)*
Preferred Pronoun*
Current academic experience/setting.*
Areas of support needed (check all that apply).*

Not sureSchool concernsTransitionsRoutinesDevelopmental skillsExecutive functioningChoosing academic settingOther
If "other", please describe.
To the best of your ability, please share your goal(s) for our work together.
What is important to know about your child? (strengths, challenges, areas of growth, temperament, developmental history etc.
What package are you interested in?*

30-minute consultation1- hour consultationEmail consultationSupport Session- VirtualSupport Session- In-homeNot sure- please help!
What is the best way to reach you?*

Phone callEmailText
If you selected 'text' or 'phone call', please provide your phone number.
Should be Empty:

Let's get to know each other a bit more.