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Advocacy Parent Intake Form
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Parent First Name
*
Parent Last Name
*
Parent Email Address
*
Mobile Phone
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Address
*
City
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State
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Zip
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Child's First Name and Last Name
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Child's Grade
*
Child's Birthdate
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Child's Age
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What type of school do they attend?
Public
Private
Non-Public (Charter)
Home School
Residential Placement
Other
Does your child already have an IEP?
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Yes
No
Last IEP Meeting Date
Last IEP Assessment
Is their case currently involved in due process, mediation, and/or a settlement agreement?
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Yes
No
Are you their Legal Guardian?
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Yes
No
Full School Name
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School District of Attendance
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Do they have a 504 Plan?
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Yes
No
Last 504 Meeting
Support Needed: Are you currently working with a Special Education Advocate or Attorney?
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Yes
No
What do you want the school to do?
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Test my child
Hold an IEP meeting
Giver better/new support
Conduct better assessments
Start the IEP process
Other
Why are you seeking advocacy support?
To get my child their first IEP
To communicate better with my child's school
To better understand the reports
To achieve better IEP or 504 meetings
Other
Which Advocacy Service are you interested in?
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Initial Intake and Strategy Package (File Review)
Evaluation Package
Meeting Package
Why do you wish to hire a special education advocate?
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Desired Start Date
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How did you hear about Sankofa Ed?
Client Referral
Sankofa Ed Website
Google
Facebook
Instagram
Other
I understand that Sankofa Ed does NOT provide services for due process claims, civil claims, or mediation agreements.
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I understand that Christina Damon is a non-attorney special education advocate and DOES NOT PROVIDE legal advice.
*
I understand this questionnaire is for informational purposes only, and all educational decisions are my own.
*
Upon submitting, you will be sent to my calendly link to schedule a zoom appointment
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15 Minute Complimentary Consultation
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First Name
*
Last Name
Email Address
*
Phone Number
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