Request for CARE Team Consideration 
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Email *
Student Last Name *
Student First Name *
Name of person making request and relationship to the student *
Please select the school that the student attends: *
Select the grade the student is in for the 24-25 school year. *
Required
In which areas does the student have difficulties? *
Required
What assistance does the student need?  
To best be able to support the student, please explain what impedes/prevents/interferes with student learning.
*
What are the student's strengths? *
What, if any, specific accommodations are you seeking? *
Which of the following major life activities does the physical/medical/psychological condition impact?  *
Required
Do you have medical documentation of the student's condition indicating its impact on a major life function? *
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