IEP Support Request Form
Please fill out the following form to provide us with a bit of information about your child's educational and behavioral needs at school. Please note that free IEP support and other school related supports are only available to children in the public school setting as private schools are not required to adhere to IDEA. 

If you are looking for school support for a person without PWS, or a person with PWS attending a non-public school, please visit: https://www.empoweredsolutions.org/
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Child's Name
Have you ever received IEP Support from us before? *
What is your child's age? *
What grade is your child in? *
What state do you reside in? *
Does your child currently have an IEP? *
What type of support are you looking for? *
Required
Does your child engage in behavioral challenges at school? *
Required
If you answered yes above, please describe your child's school related behavior challenges. 
Please describe the challenges that you are experiencing with your child's school and IEP process below.  *
Your name *
Phone number *
E-mail *
Do you consent to Dr. Destiny Pacha and Dr. Kasey Bedard to provide consultation on your child's educational and behavioral progress at school, and to review documents including your child's IEP and school behavior intervention plan as part of the process of providing consultation? *
Please type your name below to indicate that you consent to consultation.  *
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