• IEP Review & Advocacy Intake Form

    Please provide detailed information about your child's educational needs and concerns to help us assist you effectively.

  • Parent / Guardian Information

  • Format: (000) 000-0000.
  • Preferred Method of Contact*

  • Student Information

  • Date of Birth*
     - -
  • Current Placement*

  • Upload Documents

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  • Educational & Diagnosis Information

  • Child’s Diagnosis*
  • Receiving Therapy Services*
  • Where are services provided?*

  • Behavior & Safety Concerns

  • Does your child have a history of elopement (running off)?*
  • Does your child exhibit any of the following?
  • Are there safety concerns at school?*

  • Discipline & Suspensions

  • Has your child been recommended for alternative school?
  • Has your child been Baker Acted or hospitalized?

  • IEP Support & Services

  • Do you feel the current IEP is being followed?*
  • Do you feel your child is making progress?*
  • Has a Behavior Intervention Plan (BIP) been created?*
  • Has a Functional Behavior Assessment (FBA) been completed?*

  • Communication with School

  • Have you requested meetings that were ignored or delayed?*
  • Have your concerns been documented by the school?*

  • Parent Goals

  • What outcomes are you hoping for?*

  • Additional Information

  • Consent

  • Consent Statement: I understand that Strong Parents Strong Voices will review the information provided for advocacy purposes. This is not legal advice but advocacy support.

  • Date*
     - -
  • Should be Empty: