Grow

GrowNOW Intake Form
YES - Parents always have a free conversation with the Best Fit Coach before moving forward. Please Complete Form 100%

We use the information you provide to determine your Best Fit Coach - so be as detailed as possible! Please do not pursue these services if you are still skeptical or unsure.
Service you are requesting (all services are non-medical) you can select multiple. Do not stress over choosing the right program, nothing is rigid:

Direct Coaching - Executive Function, Life, Parent (Child+Parent) - $150/hrParent Coaching Only (No Child Involvement) - $150/hrSocial Executive Function Groups (Virtual+In-Person) - $150/hrCollege Success Program - $150/hrYoung Adult Independence Program - $150/hrYoung Adult Job Coaching & Healthy Interests Program - $150/hrHomeschool Hope Program - $150/hrSummer Executive Functioning-Camp: EF-CampOutdoor Play Groups (Downingtown, PA) - EF Social OutpostThe Reading Confidence Project - Literacy Program1-1 Dad Coaching ($200/session)Mom Support Groups ($35/session)Dad Support Groups ($35/session)
Student First & Last Name*

First NameLast Name
Student First & Last Name*
Date of Birth

MonthDayYear
Age*
Gender

MaleFemaleOther
Address - REQUIRED*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of School Student Attends

Fill the below details:

Enter your Email*
Please double-check your email ID. To access your information, you must use the same email ID further.
How did you hear about GrowNOW
Background Information and Goal Setting
Please outline your concerns regarding the students ADHD in the following areas Home, Social, School and/or Work - REQUIRED*
What does a typical day look like for the student?
What specific goals would you like to set for the student?
What does screentime currently look like for the student?
Additional Information
Availability

Select below (can select multiple):

	select
Raleigh, North Carolina Clinic
Los Angeles, CA Clinic
New York, NY Clinic
Boston, MA Clinic

Please select your available times. All times below are listed in Eastern Time (ET), USA. We will work around your availability and your time zone.

The more times you list, the easier it will be to have your schedule match with your Best Fit Coach's schedule.

Confirm your Available Times*

Do you have any specific questions, comments, or concerns for us? Please write out all thoughts here so Mike & Amy can answer them directly for you! During your time with GrowNOW, both Mike & Amy are always available to you: Mike@GrowNOWADHD.com and Amy@GrowNOWADHD.com - Please make sure to watch all the FAQ Videos on the website first!
Email Campaign

Add me to the mailing list.
To help make your time with us short and productive, you will need to supplement with the two GrowNOW Books written by Michael McLeod.

The Executive Function Playbook & The Executive Function Playbook in Action Workbook.

Links to Purchase Here:

1) Book: Amazon

2) Workbook: Amazon
Are you purchasing now or do you already own?*
You must now complete our Policies Form to be added to our waiting list
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GrowNOW Intake Form