School Contact Email (###) ### #### What age range are you seeking support services for? (Select all that apply) Preschool Elementary School Which population are you seeking support services for? (Select all that apply) Individual students Classrooms or groups of students Educators Support staff What type of support services are you seeking? (Select all that apply) Consultation services (for students, groups of students, or staff) Inclusive and neurodiversity-affirming classroom design development Program or curriculum development Handwriting program Other: (please explain in the additional information section at the end) What are you observing or experiencing that prompted you to seek out OT services? Do you have any additional information or thoughts you would like to share, or anything else that would be helpful for us to know? Thank you! Your intake form was received. EDUCATION CONSULTATION INTAKE FORM