Joy of Learning Intake Questionnaire
Please complete this questionnaire before our phone consultation. Thank you!
* Indicates required question
Parent Guardian Name *
Your answer
Parent/ Guardian Phone *
Your answer
Location (city) *
Your answer
Student's Name *
Your answer
Student's Age and Grade *
Your answer
What are the academic areas in which your child needs support? *
Your answer
Does you child have any diagnoses and have they had any particular evaluations? *
Your answer
Are you interested in one-on-one work or small group work? *
What days and times generally work best for your schedule, and are there days and times that don't work? (When I get a lot of inquiries, I reach out first to families whose availability matches with the time slots that I currently have available). *
Your answer
Anything Else?
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