Consultation Intake SurveyConsultation FormΔFirst NameLast NameChild's AgeAnswer the following questions to your level of comfortability. Please prioritize answering the questions in bold; this will make our time together the most productive it can be for you. 1. What type of neurodivergence has your child been diagnosed with and for how long?2. What are some of your favorite strengths of your child?3. Are there any other family members who exhibit neurodivergence or who have been formally diagnosed?4. What areas of your life do you think are going well at the moment?5. In what areas of your life do you feel the most supported?6. Tell me a little about your support system:7. What areas of your life are not going well for you at this time?8. In what areas of your life do you feel disconnected or lacking support?9. What are some of your biggest struggles in this phase of parenting?10. What other things in your life make this even more challenging?11. What is the one area of your life where you want to see progress?Submit Form
