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Public Funding Inquiry

Thank you for your interest in working together.

Some families are able to use public funding to cover the cost of special education consulting and advocacy services. Complete the short form below and I'll review your information to determine the best way to move forward.

Parent/Guardian Name

Email Address

Phone Number

Child's First Name

State

Which public funding source are you currently using?

Have you already been approved to use your funding for educational consulting or advocacy?

A
B
C

If applicable, what is the name of your Regional Center, FMS, Support Broker, Care Management Organization, or other funding organization?

Briefly tell me how I can help.