Synergy Autism - Wait List
Hello. Thank you for your interest in services. I would love to meet with you and hear more about your needs however, I am currently very busy serving many other lovely individuals, teams and families. I ask that you fill out this online form to be added to my wait list. The form asks questions about your needs and I will review entries as soon as I am able to respond. Should you have any other questions, please contact me at
barbara@synergyautismcenter.com
* Required
Email address
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Your email
Your name
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Your answer
Type of support you are seeking
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For myself - to better understand my own autism
For me, as a parent, to better understand my child's autism and how to best support them
For me, as a loved one, to better understand my family member's autism and how to best support them
For me, as a professional, to better understand my client/patient's autism and how to best support them
A combination: to support both my teen/adult child with autism and myself as their parent(s)
Other:
Required
Age of the person with autism or suspected of having autism in your life (your age, if you are wishing for services for you)
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Your answer
What are you hoping for from my services?
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Your answer
Would you like to be added to my e-newsletter?
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Yes
No
A copy of your responses will be emailed to the address you provided.
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