October 2022 – Currently closed to new clients due to a full caseload. Please check back in January 2023. STEP 1: SELECT A MEETING TIME STEP 2: Complete the CONFIDENTIAL Intake form Initial IEP Consultation (New Clients) Caregiver InformationFirst Name Last Name Email Preferred Pronouns AddressStreet Address City Province Postal Code Child's InformationChild's First & Last Name Child's Preferred Pronouns Child's Age Child's Current Grade Child's Primary IEP Designation - Select -A - Multiple NeedsB - DeafblindC - Intellectual DisabilityD - Chronic HealthE - Visual ImpairmentF - Deaf or Hard of HearingG - AutismH - Mental HealthK - Intellectual DisabilityP - GiftedQ - Learning DisabilitiesI'm not sureMy child does not have a designationSecondary IEP designation (if applicable) Please tell me a little bit about your current situation and the type of support you hope for: School InformationName of Child's Current School Name of School District School Team MembersPlease share the names of your school-based team members. If some fields don't apply to your team, leave them blank. Filling these names in helps me to review emails and prepare for team meetings more efficiently.Principal Case Manager (this is usually the person who writes the IEP - Resource Teacher/Inclusion Support Teacher) Classroom or Homeroom Teacher EA/Support Staff School Counsellor Other team members or district administrators: Payment PreferencePlease review the options below and select the one that works best for your family. I endeavour to provide an equitable service model so please contact me directly if you require personalized arrangements other than the options described below. The initial consultation is billed at $250 CAD (2 hours)Follow-up consultations are billed at $125/hr CADPlease select your preferred form of payment: Direct Payment vis eTransfer (I will invoice you after the consultation) Bill to AFU (I will invoice AFU directly once approved) I have read and agree to the Terms and Conditions and Privacy PolicySubmit Form