SNACS, LLC – Free Consultation Intake Form

SNACS, LLC – Free Consultation Intake Form

Thank you for reaching out to SNACS, LLC. We’re here to help you strengthen your role as an advocate for your child or family member. Please complete the information below to help us understand how we can best support you.
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Recipient of Care (IHSS/Regional) or Child with IEP/504's Information
Name

First NameLast Name
Age
Areas You Are Seeking Support With

IHSS (Application, Appeals, Back Pay, Denial Support)IEP (Review, Meeting Preparation, Advocacy Support)504 Plan (Eligibility, Modification, Support Planning)Regional Center Services (Intake, IPP, Service Navigation)Parent Coaching & Empowerment
Briefly Describe Your Current Concern or Question
SCHEDULE FREE CONSULTATION
IMPORTANT NOTE FOR IEP/504 ADVOCACY:

If you are seeking IEP or 504 advocacy, please send us a copy of your child’s latest IEP or 504 plan after submitting this form in advance.
You may email it to: snacs.co@gmail.com

Next Steps: Once we receive your form, we will contact you within 1–2 business days to schedule your free consultation.
Authorization & Signature: I confirm that the above information is accurate and I am requesting support from SNACS, LLC.Authorization & Signature

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Recipient of Care (IHSS/Regional) or Child with IEP/504's Information