Jad's Inclusion – Learning Delay / Special Needs center
Please fill-out the below form and one of our staff will contact you to schedule a free of charge assessment. Student First Name (required)
GenderMaleFemale
If Parents Are Divorced, Who has Legal Custody?MotherFatherBoth
Are there confidential, psychological, or special education reports from the student’s former school?YesNo
Has your child ever been held back in any grade?YesNo
Please list the services the student has received or is currently receiving, mentioning the date, period, and provider:
Submit
