LEAD Innovation Studio Resource Request
A number of resources exist to help Park Hill School District families. If your family could benefit from any of the resources listed below, please check the service(s) you feel would be helpful. All information received and any service provided is kept strictly confidential. We look forward to providing support to your family. Upon return of this completed form, the School Social Worker will either send you information or applications based on the needs indicated, or contact you directly for further information.  ​If you have any questions, please feel free to contact LEAD School Social Worker, Betsy Chociej at  ChociejE@parkhill.k12.mo.us or (816) 359-6417.
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Email *
Student Name *
Parent/Guardian Name *
Please check one of the following: *
Contact Information (Phone or email) *
Resources Needed (Please check all that apply)
Other Information:
My Child (or I) could benefit from support with:
Once this form is filled out and submitted, the social worker will send information or applications based on the needs indicated, or contact you directly. By digitally signing this form, you give the School Social Worker permission to provide referrals to community resources. Please digitally sign your name below. *
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