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
Type of support you are seeking
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)
Age of the person with autism or suspected of having autism in your life (your age, if you are wishing for services for you)
What are you hoping for from my services?
Would you like to be added to my e-newsletter?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Synergy Autism Center.