Special education support Name(Required) First Last Email(Required) Child's name(Required) Child's age(Required) Child's grade(Required) School currently attending(Required) School district (if ESA homeschooled, the district you reside in)(Required) Do you have any of the following?(Required) MET Report IEP 504 Outside evaluations pertaining to your educational concerns (including psychological, psychiatric, medical, vision, hearing….) None of the above What would you consider a short term successful outcome for your child?(Required)Consent(Required) I agree that I am disclosing my private information to Love Your School. I acknowledge that Love Your School agrees to protect my private information and only use it internally for the purpose of providing support. I acknowledge that Love Your School does not provide legal advice. I acknowledge that I have had the opportunity to ask questions and such questions were answered clearly and to my satisfaction.WHAT TO EXPECT Love Your School’s Parent Concierge Service seeks to help families navigate their school choice options. Each family will be connected to a specialist(s) who will address their individual concerns. Love Your School does not provide legal advice but seeks to support and empower parents. Any information Love Your School provides does not, and is not intended to, constitute legal advice; instead, all information provided is for informational purposes only. CONFIDENTIALITY We respect each and everyone's right to privacy and confidentiality and we will make sure to maintain it that way. Love Your School will not disclose parent or student private information to any organization or person outside of Love Your School without prior written consent from the parent. However, please understand that this is not absolute and is limited to provide for by law. Certain limitations are as follows: Threatening one's self or another that may result in physical harm; An act of physical or emotional abuse against a child or any person; Sexual abuse against a child where the child is living with the abuser; Required by court order. However, we shall notify you and let you exercise your privilege in the right to deny the disclosure of your records with us. Your prior written consent to release records. QUESTIONS OR CONCERNS If you have any questions or concerns regarding the information in this form please call +1 480-418-6975. Δ
