Minneapolis Rett U Interest Form
Rett University will be in Minneapolis for the ASCEND National Summit from July 1-July 3. If you are interested in doing an in-person consultation with Ms. Kourtney either before or after the conference, please complete this interest form. If you have any questions, or would like an estimated cost, please email kourtney@gp2c.org. Please submit form by June 5th, Ms. Kourtney will contact you to schedule a session.
Client Name
*
First Name
Last Name
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client Information
*
Reason for Consult, Age, AAC device info, etc.
I would like to schedule with Ms. Kourtney
*
Before the conference
After the conference
I am flexible
If there are any special scheduling circumstance, please describe below.
Ex. Limited time, flying in this time, etc.
Submit
Should be Empty: