Evidence-Based Tutoring Consultation Request
Thank you for your interest in Evidence-Based Tutoring. Please share a little about your child and the support you are seeking. Davisha will review your information and contact you to discuss fit, availability, and next steps.
Parent/Guardian Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone call
Text message
Student Information
Student First Name
*
Student Age
*
Current Grade
*
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
School Name (optional)
Diagnosed or Suspected Learning Difference (optional)
Dyslexia
Dysgraphia
ADHD
Speech or language history
None or unsure
Other
Tutoring Needs
Areas of Support Needed
*
Reading and decoding
Spelling
Reading fluency
Reading comprehension
Written expression
Handwriting
Study skills
Other
Please share your main concerns, your child’s strengths, and what you hope to see improve.
*
Preferred Tutoring Format
*
Online
In person in Atlanta
Hybrid
Unsure
Days and times your child is generally available
*
How did you hear about Evidence-Based Tutoring? (optional)
Referral
Wyzant
Google search
Social media
School or professional
Other
Anything else Davisha should know before contacting you? (optional)
Submit Consultation Request
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