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Joy of Learning Intake Questionnaire
Please complete this questionnaire before our phone consultation. Thank you!
* Indicates required question
Email
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Your email
Parent Guardian Name
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Your answer
Parent/ Guardian Phone
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Your answer
Location (city)
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Your answer
Student's Name
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Your answer
Student's Age and Grade
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Your answer
What are the academic areas in which your child needs support?
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Your answer
Does you child have any diagnoses and have they had any particular evaluations?
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Your answer
Are you interested in one-on-one work or small group work?
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One- on-one only
Small Group Only
Either
What days and times generally work best for your schedule, and are there days and times that don't work? (When I get a lot of inquiries, I reach out first to families whose availability matches with the time slots that I currently have available).
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Your answer
Anything Else?
Your answer
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