Professional Development Request Form – Go Beyond Abilities Clinical Services

Professional Development Request Form – Go Beyond Abilities Clinical Services

Thank you for your interest in booking Dr. Amanda Randall for your professional development needs! Please complete the form below so we can tailor a high-impact experience for your team.
Hourly Rate for Live Presentation: $150/hour

Prep Time: $150/hour (typically 2–3 hours for custom PDs)

Half-Day Flat Rate (up to 3 hours): $500–600

Full-Day Flat Rate (4–6 hours): $900–1,200

Travel Expenses: Covered by host (mileage, lodging if needed)
Name

First NameLast Name
Organization
Email
example@example.com
Phone Number
Please enter a valid phone number.
Preferred Date (s)

MonthDayYear
Date
Preferred Date (s)

MonthDayYear
Date
Preferred Time (s)
Format

In-PersonVirtualHybridOther
Location if in-person
Type a question

1 hourHalf-day (2–3 hours)Full-day (4–6 hours)Other
Topic Preference

I have a specific topic in mind (please describe below)I’d like to meet with Amanda to discuss specific needs and determine a topic based on our needsOther
Specific Topic Request
Audience Type and Size
Tell us who will be in the audience (teachers, admins, BCBA's families, etc.) and how many people you expect.
What is your main goal for this session?
(e.g., build team skills, manage student behavior, improve IEP collaboration)
Is there anything else Amanda should know to prepare?
(e.g., previous trainings, known challenges, key initiatives)
Should be Empty: