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Neuroaccessibility Coaching - Waitlist
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Pronouns
Your answer
Idenities you'd like to share (i.e. neurodivergent, CALD, disabled, fat, etc.)
Your answer
Home address
*
Your answer
Which of the below best describes you? (Annie primarily supports ND Adults, but she also helps parents/carers and professionals who would like to learn how to be more neuroaccessible for their children and clients - use the "other" checkbox if you need it)
*
Neurodivergent (Autistic/ADHD) Adult
Neurodivergent (Autistic) Adult
Neurodivergent (ADHD) Adult
Neurodivergent (unsure) Adult
Other:
Required
Are you diagnosed or self-identified? (both are valid here)
*
Diagnosed
Self-identified
Other:
Required
What do you hope to gain from 1-on-1 Coaching with Annie? Or how do you think she can help you?
*
Your answer
What are your biggest struggles right now? Or what would you like support with? (i.e. workplace "reasonable adjustments", accessing the NDIS, self-advocating in healthcare settings, self-employment mentoring, etc.)
*
Your answer
Tell us a little about your story or whatever you think will help give Annie context or background to best support you.
*
Your answer
What is your coaching preference?
*
A few sessions
Ongoing Coaching (10+) - note discount is available
Ongoing Coaching (long term support)
Other:
Required
What are the areas that you most need help with? (please use "other" to add anything that isn't on this list)
*
Executive Functioning
Sensory Processing Support
Communication/Social/Relationships
Burnout/Mental Health
Seeking Diagnosis
Navigating NDIS (National Disability Insurance Scheme for Australian clients only)
Neuro-affirming practice (for allied health and medical practioners)
Neuro-affirming partenting (for carers of ND children and/or ND parents)
Self-advocacy
Chronic Illness Supports
Self-acceptance and self-compassion
Other:
Required
Which environment do you find the least neuroaccessible (meaning the most challenging and unaccommodating to your neurodivergent needs)?
*
Home
Community
Healthcare
Employment
Education
Other:
Required
What supports and services have you already tried to get support from?
*
Allied Health (OT, Speech, Social Worker, etc.)
Allied Health (Psychology)
Medication
Employment/Education modifications (or adjustments)
Professional Organiser/Coaching
Courses/Webinars
Assistive Technology
Support Workers
NDIS (National Disability Insurance Scheme for Australian clients only)
Professional Development
None yet
Other:
Required
Where are you on your ND discovery journey?
*
Barely starting to suspect that I'm neurodivergent
Early days (less than 12 months since realising I could be ND)
Still pretty fresh (1-2 years)
Starting to settle in (3-5 years)
Known for a long time (6+)
Not ND - but want to be an ND Ally
Other:
Required
How old were you (or your child) when you discovered your (or their) neurodivergence? (not relevant for non-ND professionals)
Under 14
15-17
18-24
25-29
30-34
35-49
50+
Other:
How did you hear about Annie Crowe or her work? What brought you here to wanting her support?
*
Your answer
Would you be interested in any of Annie's events or programs? (if yes, you'll be first to know when they go live!)
Princess and the Pea Podcast related interviews
ND Masterclasses (in eating disorders, burnout, trauma, relationships, etc)
Beginners Guides (to seeking diagnosis, to navigating therapy, to advocacy, etc)
NDIS Courses (on applying, self-management, using funding, etc.)
NeuroAccess Network (for ND Adults) - launching early 2024)
Any public appearances Annie does!
Professional development for NeuroAccess@Work
Professional development for Allied Health Professionals
Professional development for NDIS support workers
Other:
If there is any specific topics or areas you'd like to learn from Annie that isn't included in the list above, feel free to let us know here.
Your answer
Most importantly: any accessibility needs or preferences we can support you with? (this includes captions, live or recorded sessions preferred, tech keen/experienced or tech avoidant/trouble, email/phone calls, etc.)
Your answer
Any other comments or information you would like to share?
Your answer
Send me a copy of my responses.
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