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Tracing Talent Coaching Application
This form is intended as a first step in our onboarding process. Please answer as honestly as possible. Please call us at 780-226-5956 with any questions.
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* Indicates required question
What is
your
name and your
child's
name?
*
Your answer
Please leave the best
phone number
and
email address
to reach you at.
*
Your answer
What is the age of your child?
*
Your answer
Tell me about your child’s personality.
*
Your answer
What are your child's interests?
*
Your answer
What are your child's strengths?
*
Your answer
What are your top areas of concern?
*
Your answer
Does your child have any health problems (suspected or diagnosed)?
*
Your answer
Please tell me a bit about your child’s educational history. Have they always struggled in these areas? Have they switched schools or teachers frequently? Does your child have any known learning disabilities? (Have an IEP/IPP, or see another type of learning specialist such as SPL, OT, etc). *It's ok if you are not sure.
*
Your answer
Does your child have good friends?
*
Yes
No
Have there been any big shifts in your child’s life?
*
Your answer
Tell me about your family structure. (How many kids do you have, what are their ages, who lives with you, are both parents at home, etc).
*
Your answer
Because we take a holistic approach, we need to be aware of all things that influence your child's performance. Are you willing to disclose your child’s eating habits, daily schedule, family habits, and more?
*
Yes
No
What are you hoping to get out of our time together?
*
Your answer
Comment or questions:
Your answer
Thank you for providing us with some initial information! We will be in touch soon. We look forward to working with you!
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