• LaunchPoint Inquiry Form

  • Relationship to Client*
  • Format: (000) 000-0000.
  • What is your child's current educational status?*
  • What is your current educational status?*
  • What is your child's current employment status?*
  • What is your current employment status?*
  • Is your child aware that you are exploring this service for them?*
  • What are your primary goals for your child as they transition into adulthood? (Select all that apply)
  • What are your primary goals as you transition into adulthood? (Select all that apply)
  • Do you and your child experience tension or disagreements about their next steps in life?
  • Would you be open to participating in parent-only sessions to support your child’s transition?
  • Which services are you most interested in for your child? (Check all that apply)*
  • Which services are you most interested in? (Check all that apply)*
  • What do you believe will be your child’s biggest challenge in our working relationship?
  • Are you financially prepared to invest in services for your child?*
  • Are you financially prepared to invest in services?*
  • Would you be interested in a quick 15-minute consultation call to discuss whether this is a good fit?*
  • How did you find out about our services?*

  • CONFIDENTIALITY:

    I understand that all information I entered in this form will be considered strictly confidential.

    The data gathered from this form will only be used as a basis for information gathering and assessing.

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