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Your Contact Information
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First/Last Name
Email Address
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Child's Name
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First/Last Name
Age/Grade
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School Information
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Please include basic information. If this is a transition to kindergarten, middle school, or high school, then include the name of that school instead.
School District Name
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Questions and Details:
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What is your child's current situation at school?
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IEP or 504 plan? Eligibility Category, Medical Diagnosis, classroom attendance?
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What are your top 3 concerns with your child's IEP or 504 plan?
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Ex. lack of progress, services not being received, behavioral issues, etc
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More room for concerns:
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What outcome are you looking for?
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9
You will receive a response of receipt within 24 hours by email.
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