Facebook Ad Questionnaire
Thank you so much for your interest! Please fill out the questionnaire below and we will contact you as soon as possible. Please feel free to email any questions to cra@ucsd.edu! We look forward to connecting with you !
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Your Name *
Your Child's Name *
Do you have a child diagnosed with Autism Spectrum Disorder who is 3-5 years old?
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Would you prefer to be contacted via a phone call or an email?
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Please let us know your preferred email to be contacted at:
Please let us know your preferred phone number to contact you at:
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