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Let’s get started
This short form will help me understand your situation before we connect.
Takes about 3–5 minutes.
There’s no pressure, just share what you’re comfortable with.
What is your name?
*
What is the best email to reach you?
*
What is your phone number? (optional)
What’s bringing you here right now?
*
Just a few sentences is perfect.
What are you navigating?
*
(Select all that apply)
What are you navigating?
Self-Determination Program (SDP)
Considering SDP
IEP or school support
Exploring options / not sure where to start
Ongoing support / coordination
Something else
Where are you in the process?
*
Where are you in the process?
Just getting started
In the middle of things
Feeling stuck or overwhelmed
Looking for ongoing support
What feels most challenging right now?
Are you currently working with a Regional Center?
Are you currently working with a Regional Center?
Yes
No
Not sure
How soon are you looking to get support?
*
How soon are you looking to get support?
As soon as possible
Within the next few weeks
Just exploring for now
Is there anything else you’d like me to know before we connect?
You don’t need to have all the answers, just share what you can
Schedule your free consultation