Request for Initial Consultation

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So glad you're here! Please complete this initial request for consultation with Breea Rosas, Ed.S, NCSP, LEP. Once submitted, Breea will reach out to you within 2 business to schedule your free 30-minute consultation Zoom call.

Email *

Name *

Role or Position *

District Adminstrator

Educator

Parent/Guardian

Other:

Services you're interested in *

Professional Development for Staff

Coaching and Consulting for Staff

Coaching and Consulting for Individual Educator/Service Provider

Neurodiversity Affirming Evaluation for Child or IEE Request

Advocacy for Child and Family

Other:

Required

Additional Information

Time/date preferences *PST

After 4:00pm (M-Th)

Before 12:00pm (Sat/Sun)

After 12:00pm (Sat/Sun)

Monday

Tuesday

Wednesday

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Saturday

Sunday

How did you hear about ND Affirming School Psychologist? *

Instagram

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Therapist Neurodiversity Collective Directory

A Dime of OT Directory

Undivided Directory

Other:

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