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Neuro-Affirming Parenting Consult & Home Harmony Session Intake Form
Is your child receiving any current therapies or interventions (e.g., speech therapy, occupational therapy, behavioral therapy)? Required
Parenting Challenges & Goals What specific challenges or concerns are you facing in parenting your neurodivergent child? (Please check all that apply) Required
What are your main goals for this consultation? (Please check all that apply) Required
How would you describe your parenting style? Required
Do you have a support system in place (e.g., extended family, therapists, support groups)? Required
Were you referred to Raising Brain? Required

Member

At Raising Brain, we are committed to providing an inclusive learning environment that welcomes individuals of every ability, race, gender, and background. Discrimination of any kind is not tolerated within our school community. We embrace diversity and strive to create a safe and supportive space where all students can thrive academically, socially, and emotionally.

© 2025 Raising Brain, L.L.C.

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