Intake Questionnaire

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PLEASE REMEMBER TO BRING THE FOLLOWING ITEMS (WHERE RELEVANT)
TO YOUR INITIAL CONSULTATION SO THAT WE CAN GIVE YOU OUR BEST ADVICE. PLEASE NOTE THAT WE WILL NOT KEEP ANY OF THE DOCUMENTATION YOU PROVIDE UNLESS YOU DECIDE TO RETAIN US, IN WHICH CASE WE WILL REQUEST COPIES.

Document Checklist for Initial Consultation

___ Current IEP

___ Past IEPs

___ Testing completed by the school district, including Psychological Testing, Educational Testing, Social History, Speech Evaluations, Occupational Therapy Evaluations

___ Progress Reports

___Reports by private professionals including: medical doctors, psychiatrists, psychologists,
developmental pediatricians, speech therapists, occupational therapists, physical therapists, neurologists

___Notices from school district personnel regarding any special education matters relating
to your child.

___Notices from any public agencies—including the Department of Education or Truancy
departments concerning any matters relating to your child

___Copies of any letters of documents sent by you pertaining to your child’s special education matter.

When it doubt, kindly bring your records. They greatly assist us in helping us identify where we can be of use to you.